A 32-year-old man presented, complaining of a painful erection for the last 18 hours. His medical history was significant for sickle cell disease, insomnia and depression, for which he was taking quetiapine, bupropion, and prazosin. Examination revealed a mildly tender, fully erect penis and a soft glans. He was given 0.25 mg of subcutaneous terbutaline, with no improvement of symptoms. A color Doppler ultrasonograph in the transverse plane was taken before definitive treatment.
Which of the following is NOT an possible treatment for priapism?
- Perineal massage
- Sedation with ativan
- Phenylephrine instillation into the corpora cavernosa.
- Epinephrine instillation into the corpora cavernosa
This case was taken from Annals, the article discusses the use of ultrasound for determination of high flow vs low flow priapism, well described in urology literature, it is a non invasive and effective way to look for arterial pulsations vs low flow states.
Eric B. Tomich, Robert Blankenship. Painful Erection. Annals of emergency medicine 1 September 2008 (volume 52 issue 3 Page 202 DOI: 10.1016/j.annemergmed.2007.11.029) (more…)