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Priapism associated with pregabalin
Ali A Alsulihem1, Danny M Rabah2
1Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Urology Annals
|November 6, 2014
Summary
Priapism, a persistent erection, can cause erectile dysfunction. This case highlights pregabalin as a potential drug-induced cause, requiring further investigation into its effects on penile physiology.
Area of Science:
- Urology
- Pharmacology
- Andrology
Background:
- Priapism is a urological emergency often leading to erectile dysfunction.
- Diverse etiologies include hemoglobinopathies, neurological disorders, and pharmacologic agents.
Observation:
- A case report details an Asian male experiencing prolonged priapism (3 days) after pregabalin use for chronic back pain.
- Initial treatments including aspiration, phenylephrine, and a Winter shunt were ineffective.
Findings:
- An El-Ghorab shunt procedure successfully achieved detumescence and pain relief on the 5th day of presentation.
- Pregabalin's potential role in inducing priapism is hypothesized via α2δ1 calcium channel subunit interaction or noradrenergic presynaptic inhibition.
Implications:
- This case suggests pregabalin as a potential iatrogenic cause of priapism.
- Further research is needed to elucidate pregabalin's precise mechanism of action on penile smooth muscle and its broader implications for erectile function.
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