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Pharmacologic erection: time-dependent changes in the corporal environment

G A Broderick1, R Harkaway

  • 1Division of Urology, University of Pennsylvania, School of Medicine, Philadelphia.

International Journal of Impotence Research
|March 1, 1994
PubMed
Summary
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Priapism, a persistent erection, can occur after medication. Prompt treatment with aspiration and phenylephrine is effective, with prolonged erections showing significant acidosis and hypercarbia.

Area of Science:

  • Urology
  • Andrology
  • Pharmacology

Background:

  • Priapism is a persistent erection unresponsive to detumescence.
  • Pharmacologically induced priapism is a common challenge for urologists.
  • Prostaglandin E1 (PGE1) is frequently used for diagnosing erectile dysfunction.

Purpose of the Study:

  • To review the management of pharmacologically induced priapism.
  • To investigate the relationship between erection duration and penile blood gas parameters.

Main Methods:

  • Retrospective review of 366 patients undergoing PGE1/color duplex Doppler assessment.
  • Management of 14 patients with priapism via penile aspiration and phenylephrine instillation.
  • Correlation of erection duration with penile blood gas analysis (pO2, pCO2, pH, bicarbonate).

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Main Results:

  • 14 out of 366 patients developed priapism lasting over 2 hours.
  • All cases were successfully managed with aspiration and phenylephrine.
  • Prolonged erections (105-342 minutes) showed significant deoxygenation, acidosis, and hypercarbia.

Conclusions:

  • Penile aspiration and phenylephrine are effective treatments for pharmacologically induced priapism.
  • Prolonged pharmacologic erections are associated with significant physiological changes in penile tissues.
  • Early recognition and intervention are crucial for managing priapism to prevent tissue damage.