First ever case report of priapism secondary to retroperitoneal fibrosis
Aziz, W1; Rafi, A2
1: , Pakistan; 2: Aga Khan University Hospital, Pakistan
Objective; To present first ever case report of retroperitoneal fibrosis leading to priapism
Case Presentation: 46years old man known case of retroperitoneal fibrosis (RPF) presented in ER with painful erection for last 24 hours. Aspiration from corpora was done and sent for blood gas analysis which showed venous type blood suggesting ischemic priapism. Erection resolved after aspiration/irrigation and phenylephrine injection. He had left hydronephrosis secondary to retroperitoneal fibrosis for last 10months for which he had left DJ stent in place and he was on Tamoxifen 50 mg daily. His MRI abdomen was repeated to look for progression of retroperitoneal fibrosis which showed extension of fibrosis along internal iliac branches and encasing internal pudendal vessels. CT guided biopsy of retroperitoneal soft tissue around left common iliac vessel showed fibrocollagenous tissue along with adipocytes with no evidence of malignancy.Since this presentation he is having stuttering priapism which settles with relaxation techniques but sometime require aspiration +/- phenylephrine. He reports no erectile dysfunction till last follow-up, 2years since initial presentation. He has been advised surgical management for his retroperitoneal fibrosis and stuttering priapism but he is willing to continue conservative measures.
Conclusion; To our knowledge this is the first case report of retroperitoneal fibrosis leading to priapism which supports possible vascular pathogenesis (chronic periaortitis) of RPF.
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