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Experience on the Management of priapism at the Yaounde Central Hospital

Open Journal of Urology 2024年第4期14卷 244-251页

作者： Philip Fernandez Owon’Abessolo Jean Cédric Fouda Armel Essomba Cécile Etobe Achille Kpanou Yellem Yvon Gerard Beling Abanda Bright Awondo-Che Milama Steves Ndang Ngou Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Urology Service Yaound&#233 Central Hospital Yaound&#233 Cameroon Department of Surgery and Specialty Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Department of Urology University of Health Sciences Owendo Gabon

Introduction: priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1st, 2011 to January 31st, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak

关键词： priapism Treatment Experience

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priapism secondary to chronic myeloid leukemia treated by a surgical cavernosa-corpus spongiosum shunt: Case report

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Asian Journal of Urology 2019年第4期6卷 373-376页

作者： Min Qu Xin Lu Lei Wang Zhiyong Liu Yinghao Sun Xu Gao Department of Urology Changhai HospitalSecond Military Medical UniversityShanghaiChina

priapism secondary to chronic myeloid leukemia(CML)is rarely observed in the clinic.Here,we present an 18-year-old patient with priapism for over 72 h due to hyperleukocytosis.Emergent interventions such as therapeutic aspiration and intracorporal injection of phenylephrine failed before a surgical corpora cavernosa-corpus spongiosum shunt was inserted to relieve symptoms.During hospitalization,bone marrow aspiration confirmed the diagnosis of CML.

关键词： priapism Chronic myeloid leukemia Surgical cavernosacorpus spongiosum shunt

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A pathophysiology-based approach to the management ot early priapism

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Asian Journal of Andrology 2013年第1期15卷 20-26页

作者： Jason R Kovac Siu K Mak Maurice M Garcia Tom FLue Scott Department of Urology Baylor College of Medicine Houston TX 77030 USA The Chinese University of Hong Kong Department of Surgery Prince of Wales HosPital Hong Kong China Department of Urology University of California San Francisco CA 94143 USA

priapism is a rare condition that involves persistent penile erection for greater than 4 h. Distinct variants exist, each with unique characteristics. Ischemic priapism is a painful medical emergency that may occur as a result of veno-occlusion leading to hypoxia and tissue death. Recurrent bouts of ischemic priapism, or stuttering priapism, require treatment for individual attacks as well as long-term prevention. Non-ischemic priapism is associated with trauma and may be managed conservatively. Recent advances into the pathophysiology of priapism have allowed the development of treatment algorithms that specifically target the mechanisms involved. In this review, we outline the basics of smooth muscle contraction and describe how derangement of these pathways results in priapism. A pathophysiological approach to the treatment of priapism is proposed with duration-based algorithms presented to assist in management.

关键词： algorithm ischemic management priapism T-shunt tunneling

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Insights of priapism mechanism and rationale treatment for recurrent priapism

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Asian Journal of Andrology 2008年第1期10卷 88-101页

作者： Jiuhong Yuan Rowena DeSouza O. Lenaine Westney Run Wang Departments of Urology University of Texas Health Science Center and MD Anderson Cancer Center Houston TX 77030 USA

priapism is defined as abnormal prolonged penile erection occurring beyond or unrelated to sexual interest. The disorder is enigmatic yet devastating because of its elusive etiology, irreversible erectile tissue damage, and resultant erectile dysfunction （ED）. Current management strategies suffer from a poor understanding of the pathophysiology, especially at the molecular level. The traditional treatments are based more on empirical rather than evidence-based knowledge. The outcomes for restoration of normal erectile function are poor, especially for stuttering priapism. Therefore, it is critical to understand priapism from a molecular level, to formulate treatment strategies and to establish rational prevention strategies for high-risk populations, such as sickle cell disease （SCD） patients and cases of the stuttering variant. This review focuses on the recent advances at the molecular level in priapism and penile erection, and applies the recent knowledge to the treatment of stuttering priapism.

关键词： priapism stuttering priapism molecular mechanism treatment

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Malignant priapism secondary to testicular tumor

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Chinese Medical Journal 2009年第15期122卷 1839-1840页

作者： JIANG Hai ZHU Xuan-wen SHI Shi-fang XIE Li-ping TENG Xiao-dong CHEN Zhao-dian ZHENG Xiang-yi Department of Urology First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310003 China Department of Pathology First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310003 China

Malignant priapism is an uncommon clinical disease .characterized by prolonged erection secondary to the invasion of malignant neoplasm into corpora cavernosa） Penile metastasis of malignant tumors is relatively rare, and only approximately 370 cases were reported by 2006 from a wide range of primary sites with a descending order of the prostate 125 （34%）, bladder 112 （30%） and recto-sigmoid ＋ rectum 48 （13%）; only 11 cases of malignant priapisms （3%） were attributed to penile metastasis of testicular tumors. Here, we present an interesting case of malignant priapism caused by penile metastasis of a mixed germ cell tumor of the testes in a 25-year-old man.

关键词： testicular cancer priapism penile metastasis

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Acute priapism: A Revealing Inaugural Mode of Chronic Myeloid Leukemia. A Case Report and Review of the Literature

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Open Journal of Urology 2022年第5期12卷 237-241页

作者： Dimitri Mbethe Adrien Mougougou Steevy Ndang Ngou Milama Said Mohamed Moudouni Izoudine Bissiriou Giscard Smith Olagui Jean Massandé Mouyendi Urology Department of the University Hospital of Libreville Libreville Gabon Urology Department of the Mohamed 6 University Hospital of Marrakech Marrakesh Morocco Urological and Visceral Surgery Department Omar Bongo Ondimba Armed Forces Instruction Hospital Libreville Gabon

priapism is a painful and prolonged erection occurring without any sexual stimulation and not resulting in ejaculation. It most often occurs in patients with sickle cell disease. We report here the case of acute recurrent priapism revealing inaugural mode of CML in a 22-year-old patient with no particular pathological history. The study of the onco-hematological karyotype revealed a karyotype with 46 chromosomes with a clonal chromosomal anomaly: The t (9;22) “Philadelphia chromosome”. The evolution was favorable under imatinib.

关键词： priapism Chronic Myeloid Leukaemia Philadelphia Chromosome

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Penile prosthesis implant in the special populations:diabetics,neurogenic conditions,fibrotic cases,concurrent urinary continence surgery,and salvage implants

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Asian Journal of Andrology 2020年第1期22卷 39-44页

作者： Eric Chung AndroUrology Centre BrisbaneQLD 4000Australia University of Queensland Princess Alexandra HospitalBrisbaneQLD 4000Australia Macquarie University Hospital SydneyNSW 2109Australia

Penile prosthesis implant(PPI)remains an effective and safe treatment option for men with erectile dysfunction(ED).However,PPI surgery can be associated with a higher risk of complications in certain populations.This article provides a critical review of relevant publications pertaining to PPI in men with diabetes,significant corporal fibrosis,spinal cord injury,concurrent continence surgery,and complex salvage cases.The discussion of each category of special populations includes a brief review of the surgical challenges and a practical action-based set of recommendations.While specific patient populations posed considerable challenges in PPI surgery,strict pre-and postoperative management coupled with safe surgical practice is a prerequisite to achieving excellent clinical outcomes and high patient satisfaction rate.

关键词： continence surgery diabetes erectile dysfunction penile prosthesis implant Peyronie’s disease priapism salvage surgery spinal cord injury

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Non-ischemic priapism in dog: Case report

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Asian pacific Journal of Reproduction 2018年第1期7卷 47-48页

作者： El-Sherry TM Abdel-Ghani MA Department of Theriogenology Faculty of Veterinary MedicineAssiut UniversityAssiutEgypt Laboratory of Theriogenology Department of Clinical SciencesDivision of Veterinary MedicineFaculty of Veterinary MedicineHokkaido UniversitySapporoJapan

Bulldog with unilateral cryptorchidism was admitted to our clinic suffering from a persistent erection for 2 d. The animal was left for the first time for breeding without observation. Penis was hyperaemic, oedematous with area of mucous membrane necrosis and swollen bulbus glandis. Doppler ultrasound was optimized to allow adequate recognition of blood flow sensitive for slow flow on the head, shaft of the penis and bulbus glandis. Penis showed unsymmetrical blood flow that started in the left side of the bulbus glandis, and continue to the shaft until the gland penis;whereas, the other half of the penis showed no blood flow. Using Doppler ultrasonography was useful for diagnosis of the blood flow pattern that was beneficial to give the appropriate treatment.

关键词： Dog priapism Doppler

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Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors： an update

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Asian Journal of Andrology 2016年第5期18卷 723-731页

作者： Wen-Hao Zhang Xin-Hua Zhang Department of Urology Zhongnan Hospital of Wuhan University Wuhan City 430071 Hubei Province P.R. China.

Phosphodiesterase isoenzymes 5 inhibitors （PDE5-1s） are the first-line therapy for erectile dysfunction （ED）. The constant discoveries of nitric oxide （NO）/cyclic guanosine monophosphate （cGMP） cell-signaling pathway for smooth muscle （SM） control in other urogenital tracts （UGTs） make PDE5-1s promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-1s have been widely recognized. On-demand PDE5-1s are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase （sGC） stimulators also have promising role in the management of severe ED conditions. PDE5-1s are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-1s, especially combined with （z-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia （BPH） except on maximum urinary flow rate （Qmax） with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-1s are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie＇s disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-1s in disorders of UGTs are required.

关键词： benign prostatic hyperplasia erectile dysfunction overactive bladder phosphodiesterase isoenzymes 5 inhibitor priapism smooth muscle

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Management of Venous priapism: Experience of Sylvanus Olympio University Hospital in Lomé(TOGO)

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Open Journal of Urology 2018年第10期8卷 289-296页

作者： Komi Hola Sikpa Edoe Viyome Sewa Efoe-Ga Amouzou Gnimdou Botcho Ananivi Sogan Tamegnon Dossouvi Essodina Padja Boureima Ouedraogo Essomindelou Leloua Messan Semefa Agbedey Tchilabalo Matchonna Kpatcha Kevin Kodjo Tengue Université de Kara Kara Togo

Objective: To study the diagnostic, etiological, therapeutic and evolutionary aspects of patients received at the Sylvanus Olympio Hospital in Lomé for venous priapism. Patients and Methods: A cross sectional study, over 5 years (2012-2016), of 27 cases of low flow priapism treated at the Chu Sylvanus Olympio in Lomé. Results: The mean age of the patients was 28.14 years ± 8.6. The average time of consultation was 106 hours (04 days 10 hours) ± 208.02. In our study, 4 (14.81%) patients consulted before the 6th hour and 20 (74%) patients consulted after the 24th hour. The blood count required in all patients revealed a case of chronic myeloid leukemia. Hemoglobin electrophoresis resulted in 23 (85.1%) cases of sickle cell disease. The management was medico-surgical. After an average follow-up of 11 months, erectile function was evaluated in 18 patients, and erectile dysfunction was noted in 10 (55.5%) patients.

关键词： Venous priapism Urgency Drepanocytosis Neuroleptics Erectile Dysfunction

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