Priapism complications

Abu Sham a RA, Kufri FH, Yassin IH. Stuttering priapism complicating warfarin therapy in a patient with protein C deficiency. Int J Lab Hematol 2008 30(4) 339-43. 

Both vasoconstrictors and vasodilators have been used in the treatment of priapism. Vasoconstrictors are thought to work by forcing blood out of the cavernosum and into the venous return. Aspiration of the penile blood followed by intracavenous irrigation with epinephrine (1 1,000,000 solution) has been effective with minimal complications.37 In severe cases, surgical intervention to place penile shunts has been used, but there is a high failure rate, and the risk of complications, from skin sloughing to fistulas, limits its use. 

Rare painless hematuria normal Hb level heavy exercise under extreme conditions may provoke gross hematuria and complications Pain crises, microvascular disruption of organs (spleen, liver, bone marrow, kidney, brain, and lung), gallstone, priapism, leg ulcers, anemia (Hb 7-10 g/dL) Painless hematuria and rare aseptic necrosis of bone vasoocclusive crises are less common and occur later in life other complications are ocular disease and pregnancy-related problems mild anemia (Hb 10-12 g/dL)... 

Intracavernosal injection therapy should be used cautiously in patients at risk of priapism (e.g., sickle cell disease or lymphoproliferative disorders) and bleeding complications secondary to injections. 

Heparin has been associated with priapism (90). The frequency and severity of iatrogenic priapism as a result of heparin therapy seems to be greater than with any other type of medical treatment (91). However, it is uncertain whether it is heparin or the underlying thrombotic condition that causes the complication. 

Fouda A, Hassouna M, Beddoe E, Kalogeropoulos D, Binik YM, Elhilali MM. Priapism an avoidable complication of pharmacologically indneed erection. J Urol 1989 142(4) 995-7. 

Priapism has been reported as a complication of parenteral nutrition (160). 

The erectile response observed in patients without arteriogenic erectile dysfunction is usually intense and the incidence of priapism frequent. The association called Trimix shows a high incidence of complications, and the individual dose is difficult to define (Govier et al. 1995). 

The major problem of revascularization procedures is early or late closure of the anastomosis (Hauri 1998). Color Doppler ultrasonography is able to identify this complication and to detect blood flow changes that occur in the penile vessels. Rarer complications, such as aneurysmal dilatation of the anastomosis or priapism, can be evaluated as well (Bertolotto et al. 2005). 

Occasionally proximal shunting can complicate with high-flow priapism because of iatrogenic in-... 

Intracavernous injection of vasoactive drugs can rarely complicate with diffuse cavernosal fibrosis following low-flow priapism and/or cavernosi-tis (ScHWARZER and Hofmann 1991 Chew et al. 1997). 

Deficiencies of anticoagulant proteins can increase the risk of skin necrosis due to warfarin. In a 19-year-old man with protein C deficiency, recurrent (stuttering) priapism attributed to warfarin was complicated by skin necrosis, presumably because of paradoxical hypercoagulability [30" ]. Activated protein C concentrate can be used to treat such cases [31" ]. In another case, skin necrosis occurred on the pinna of an 82-year-old man with protein S deficiency after warfarin therapy for 2 weeks [32 ]. 

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