Frequency of priapism and characterization of its management in patients with erectile dysfunction treatment
Saffon, JP1; Corredor, HA1; Sandoval, CS1; Martinez, JM1; Gallego, A1
1: Boston Medical Group, Colombia
Objective: Estimate the frequency of priapism and characterisation of its treatment in patients with a diagnosis of erectile dysfunction treated with PDE5 inhibitors or intracavernous treatment in a sexual health institution during 2016.
Materials and Methods: Observational descriptive study. The clinical records of patients with a diagnosis of erectile dysfunction treated during the period between January 1 and December 31, 2016, who received oral or intracavernous medication for their disease, were reviewed. Clinical records with patients who reported priapisms, data on the incidence, duration, management, and evolution of the event were collected, as well as sociodemographic data and clinical antecedents necessary for the characterisation of this complication.
Results: During 2016, 5620 patients were treated for erectile dysfunction, 3220 (58%) were managed with oral PDE 5 inhibitors and 2400 (42%) with intracavernous medications. There is a report of 0.03% of patients treated with oral medications (n = 1) and 2% of patients with intracavernous medications (n = 48) presented priapism. The average age of the patients was 48 years (SD 11.33). Among the comorbidities, dyslipidemia was found in 10 patients (20.4%), diabetes mellitus in 10 (20.4%), hypertension in 9 (18.3%), coronary disease in 4 (8.1%), Peyronie's disease in 2 (4 %) and prostate cancer in 2 (4%). Nine patients consumed tobacco (18.3%) and four psychoactive substances (8.1%). The average of the baseline IIEF-5 was 12.5 points. One patient (2%) presented the priapism secondary to extra-institutional penile colour Doppler with alprostadil 10 mg, two patients (4%) during the initial assessment and 46 patients (93.8%) during the treatment. The average priapism duration was 7.9 hours (SD 4.5). The protocol of local measurements was effective to treat the priapism in 21 patients (42.2%), while 27 (55.1%) improved with etilefrine and only 1 required drainage and lavage of corpora cavernosa; none required surgical management. 47 patients (95.9%) were followed up between 6 months and one year, of which 4 (8.5%) needed more dose of medication to achieve a complete erection, the rest needed the same dose or less. There was no reported occurrence of corpora cavernosa fibrosis.
Conclusions: The management with local measures or etilefrine is successful and safe to treat patients that present priapism associated with PDE 5 inhibitors or intracavernosal medication treatments, in most cases.
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