Independent Predictive Factors for Occurrence of Ischemic Priapism after Papaverine Injection
5 January 2019
Purpose: To analyze the predictive factors causing ischemic priapism following penile doppler ultrasonography (PDU) with intracavernosal papaverine injection
Materials and methods: Medical records of 467 patients who underwent PDU examination following intracavernosal papaverine injection for erectile dysfunction (ED) between 2009 and 2017 were retrospectively reviewed. Patients with hematological disease anamnesis, patients taking phosphodiesterase-5 inhibitor, patients with intracavernosal injection therapy anamnesis and patients who underwent PDU with other intracavernosal vasodilator drugs other than papaverine were excluded from the study. The remaining 268 patients were divided into two groups as priapism (38 patients) and non-priapism (230 patients). The groups were compared in terms of demographic data, American Society of Anesthesiologists (ASA) score, comorbidities, international index of erectile dysfunction (IIEF) score and PDU results. The significant parameters were analyzed with binary logistic regression analysis. The receiver operating analysis was used to obtain cut-off, sensitivity and specificity values for the independent predictive factors.
Results: The age, ASA score, diabetes mellitus, IIEF score, duration of ED, peak arterial and peak end diastolic venous flow values in the 20th minute were significantly different in the two groups (p<0.001). Binary logistic regression analysis found age, duration of erectile dysfunction, IIEF score, peak arterial flow and venous flow rate in the 20th minute were predictive variables for the occurrence of priapism.
Conclusions: Young patients, patients with good IIEF score, patients with ED for a short time, and patients with normal peak arterial and venous flows are more prone to developing post-papaverine ischemic priapism.
- erectil dysfunct?on
J E halls, D V Patel, M Walkden, U Patel. Priapism: pathophysiology and the role of the radiologist. The british journal of radiology, 85(2012), 579-585.
Mohamad Habous, Mohammed Elkhouly, Osama Abdelwahab, Mohammed Farag, Khaled Madbouly. Noninvasive treatments for iatrogenic priapism: Do they really work? A prospective multicenter study. Urol Ann, 8(2),193-6.
F Martinez Portillo, J Hoang-Boehm, J Weiss, P Alken, K Jünemann.
Methylene blue as a succesful treatment alternative for pharmacologically induced priapism. Eur Urol, 39 (1),20-3.
Dilip Kumar Pal, Deepak Kumar Biswal, Bastab Ghosh.Outcome and erectile function following treatment of priapism: An instutional experience. Urol Ann, 8(1), 46-50.
Salonia A, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Vardi Y, Wespes E, Hatzimouratidis K. European Association of Urology guidelines on priapism.European Association of Urology.Eur Urol. 2014 Feb;65(2):480-9.
MS El-Basnassawy, A Dawnood, A Farouk. Low-flow priapism: Risk Factors for erectile dysfunction. BJU İnt, 89(3),285-90.
M Kılıç, EC Serefoğlu, A T Ozdemir, MD Balbay. The actual incidence of papaverin-induced priapism in patients with erectile dysfunction following penile colour doppler ultrasonography. Andrologia,42(1),1-4
R Seyam, K Mohamed, A Al Akhras, H Rashwan. A prospective randomized study to optimize the dosage of trimix ingredients and compare its efficacy and safety with prostaglandin E1. Int J Impot Res. Jul-Aug 2005.
R Shamloul, H M Ghanem, A Salem, I I Kamel, A A Mousa. The value of penile duplex in the prediction of intracavernous drug-induced priapism. İnt J İmpot Res, 16(1),78-9.
Bahgat Metawea, Abdel-Rahman El-Nashar, Amr Gad-Allah, Mazen Abdul-Wahab, Rany Shamloul. İntracavernous Papaverine/Phentolamine induced priapism can be accurately predicted with color doppler ultrasonograhy. Urology,66(4),858-60.
G M Lomas, J P Jarow. Risk factors for papaverine-induced priapism. J Urol,147(5),1280-1.
O Rajmil, F Garcia, E Fabian, L Bassas, JM Pomerol. Prolonged erections after diagnostic injection of papaverine chlorhydrate. Arch Esp Urol, 44(2), 179-82.
Mehmet Giray Sönmez, Ahmet Öztürk. İs there a relation between priapism occurring after penile doppler ultrasonography and international erectile function index score and erection hardness score levels? Turk J Urol, 43(4),439-743.
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