Noninvasive treatments for iatrogenic priapism: Do they really work? A prospective multicenter study
Mohamad Habous1, Mohammed Elkhouly1, Osama Abdelwahab2, Mohammed Farag3, Khaled Madbouly4, Talal Altuwaijri5, Marco Spilotros6, Carlo Bettocchi7, Saleh Binsaleh8
1 Department of Urology and Andrology, Elaj Medical Center, Jeddah, Saudi Arabia
2 Department of Urology, Benha University, Benha, Egypt
3 Department of Urology, Al-Azhar University, Cairo, Egypt
4 Department of Urology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
5 Department of Vascular Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
6 Department of Urology, University College Hospital London, London, United Kingdom
7 Department of Emergency and Organ Transplantati on - Urology, Andrology and Kidney Transplantati on Unit, University of Bari, Bari, Italy
8 Department of Surgery, Division of Urology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
Department of Surgery, Faculty of Medicine, King Saud University, P. O. Box 36175, Riyadh 11419
Objectives: Intracorporeal injections (ICIs) of vasoactive substances during penile Doppler ultrasound (PDU) are a common investigation for erectile dysfunction (ED) diagnosis. ICI can be responsible of priapism, a pathological condition of prolonged penile erection not related to sexual stimulation. The aim of our study is to investigate the effectiveness of physical exercise and medical treatment as noninvasive therapy to restore detumescence in prolonged erections after ICI.
Materials and Methods: Data were prospectively collected on men undergoing PDU in three urological centers. Three hundred and sixty-nine patients underwent PDU for the investigation of ED. All the participants received an ICI of quadrimix; prostaglandine E1, papaverine, phentolamine, and atropine. The data of the patients have been analyzed to record their comorbidities, results of PDU, and the complications encountered.
Results: Fifty-three patients (14.4%) developed prolonged erections. Physical exercise alone was successful in reversing prolonged erection within 30 min in 21 (39.6%) patients. Out of the remaining 32 patients, oral salbutamol induced detumescence in 18 (34%) within the observation period of 60 min. Nonresponders were managed successfully with aspiration and irrigation of corpora with saline (11 patients, 20.75%) or with Phenylephrine (three patients, 5.66%).
Conclusions: Physical exercise and oral salbutamol are safe and effective in restoring detumescence of pharmacologically-induced priapism. Noninvasive therapy may save a significant number of these patients an invasive treatment.