Priapism Lasting for Over 24 hours Induced by Intracavernous Vasoactive Agents

Han, Jun Hyun; Seo, Kyung Keun; Kim, Sae Chul

Abstract

PURPOSE
Retrospective study was done to evaluate the causes of priapism lasting for over 24 hours induced by intracavernous vasoactive agents.
MATERIALS AND METHODS
Thirteen patients of priapism lasting for 24-60 hours, induced by intracavernous vasoactive drugs, were retrospectively evaluated using medical records or by telephone interviews. Injected vasoactive drugs, providers of the drugs, purpose of the injection, reasons leaving the priapism untreated so long, treatment modalities of the priapism, and change of potency after the treatment were evaluated.
RESULTS
Only 2 patients (15.4%) were self-injected to treat erectile dysfunction by doctor's prescription. The others, who received the drugs without doctor's prescription, had injections to enhance their potency (46.1%, n=6) or to treat premature ejaculation (15.4%, n=2). The drugs injected were papaverine (23.1%, n=3), papaverine and phentolamine (23.1%, n=3) or prostaglandin E1(7.7%, n=1), but unknown in 6 (46.1%). The reasons of leaving the priapism untreated were mostly due to lack of no knowledge about the priapism (53.8%, n=7). Aspiration and irrigation with alpha-agonist of corpus cavernosum were applied to all patients. Four patients who did not respond to the treatment underwent shunt operations. All the patients complained of weakened potency after the priapism.
CONCLUSIONS
Priapism lasting for over 24 hours induced by intracavernous vasoactive drugs were mostly due to abuse or misuse of the drugs and resulted in weakened potency. To avoid this disaster, the drugs should be given to patients by doctor's prescription with full explanation about the side effects of the drug.