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Priapism: an avoidable complication of pharmacologically induced erection
A Fouda1, M Hassouna, E Beddoe
1Urology Center, Royal Victoria Hospital, Montreal, Quebec, Canada.
The Journal of Urology
|October 1, 1989
Summary
Priapism, a complication of erectile dysfunction treatments, can be predicted. Identifying patients at higher risk for this condition helps reduce its incidence during treatment.
Area of Science:
- Urology
- Andrology
- Pharmacology
Background:
- Priapism is a serious complication associated with intracavernosal vasoactive drug therapy for erectile dysfunction (ED).
- Papaverine, alone or with phentolamine mesylate, is commonly used but carries a risk of inducing priapism.
Purpose of the Study:
- To develop and validate a protocol for identifying patients at higher risk of priapism following intracavernosal injections.
- To assess the predictive value of specific patient characteristics and physiological responses for post-injection priapism.
Main Methods:
- An investigational protocol was applied to 331 men with ED of diverse etiologies.
- Risk factors evaluated included response to visual sexual stimulation and penile brachial index (PBI).
- Incidence of priapism was monitored throughout the study period.
Main Results:
- A positive response to visual sexual stimulation combined with a PBI greater than 0.8 was associated with an increased risk of priapism.
- Implementation of the protocol led to a significant reduction in priapism incidence.
- The incidence of priapism decreased to 1% in the final cohort of 101 patients.
Conclusions:
- Identifying susceptible patients through specific clinical parameters can effectively mitigate the risk of priapism.
- This risk stratification protocol allows for safer administration of intracavernosal vasoactive drug therapy for ED.
- The study demonstrates a successful strategy to lower priapism complications in ED treatment.