Ischemic priapism in South-East Nigeria: Presentation, management challenges, and aftermath issues
Ischemic priapism is the more common variety of priapism and often presents late. Outcome is largely dependent on the duration of ischemia. To determine the etiology, presentation, management, and outcome of ischemic priapism. Retrospective analysis of consecutive cases presenting to three hospitals...
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| Veröffentlicht in: | Nigerian journal of clinical practice 2016-03, Vol.19 (2), p.207-211 |
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| creator | Ugwumba, F O Ekwedigwe, H C Echetabu, K N Okoh, A D Nnabugwu, I Ugwuidu, E S |
| description | Ischemic priapism is the more common variety of priapism and often presents late. Outcome is largely dependent on the duration of ischemia.
To determine the etiology, presentation, management, and outcome of ischemic priapism.
Retrospective analysis of consecutive cases presenting to three hospitals offering specialist urological services in South-East Nigeria from January 2000 to December 2010.
Fifteen patients were assessed for clinical data and outcome.
The data were analyzed descriptively and inferentially using Statistical Package for Social Sciences (SPSS version 16, SPSS Inc., Chicago IL, USA) with P < 0.05.
Mean age was 30.5 years (standard deviation [SD] =1.63), range: 14-79 years. Onset to presentation interval ranged from 6 h to 28 days. Eight patients (53.3%) had sickle cell disease (SCD). Four patients (26.7%) had unidentified causes. The 8 SCD patients had stuttering priapism on several occasions previously. Six patients (40%) had taken oral herbal medications as treatment prior to presentation. Initial resuscitative measures were intravenous hydration, aspiration, and irrigation with normal saline in 13 patients. Glanulo-cavernous shunt (Al-Ghorab) was performed in all the patients. Detumescence was immediate in 14 and delayed in 1 patient. Three patients had transient recurrence of tumescence, while one had to be reshunted. Erectile dysfunction (ED) occurred in 7 patients (46.7%). Occurrence of ED increased significantly in patients presenting 24 h after onset of symptoms ([P = 0.032] Fishers exact test). Mean duration of follow-up was 21.9 weeks (SD = 4.1), range: 3-156 weeks.
Low flow priapism is common in our environment, and approximately half will occur in SCD patients who have had stuttering priapism previously. Timely diagnosis and treatment will reduce the probability of severe ED. In our experience, the Al-Ghorab shunt provides rapid relief. Enlightenment is vital in reducing ischemia time. Emphasis on preventive measures in SCD patients is vital. |
| doi_str_mv | 10.4103/1119-3077.175968 |
| format | Article |
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To determine the etiology, presentation, management, and outcome of ischemic priapism.
Retrospective analysis of consecutive cases presenting to three hospitals offering specialist urological services in South-East Nigeria from January 2000 to December 2010.
Fifteen patients were assessed for clinical data and outcome.
The data were analyzed descriptively and inferentially using Statistical Package for Social Sciences (SPSS version 16, SPSS Inc., Chicago IL, USA) with P < 0.05.
Mean age was 30.5 years (standard deviation [SD] =1.63), range: 14-79 years. Onset to presentation interval ranged from 6 h to 28 days. Eight patients (53.3%) had sickle cell disease (SCD). Four patients (26.7%) had unidentified causes. The 8 SCD patients had stuttering priapism on several occasions previously. Six patients (40%) had taken oral herbal medications as treatment prior to presentation. Initial resuscitative measures were intravenous hydration, aspiration, and irrigation with normal saline in 13 patients. Glanulo-cavernous shunt (Al-Ghorab) was performed in all the patients. Detumescence was immediate in 14 and delayed in 1 patient. Three patients had transient recurrence of tumescence, while one had to be reshunted. Erectile dysfunction (ED) occurred in 7 patients (46.7%). Occurrence of ED increased significantly in patients presenting 24 h after onset of symptoms ([P = 0.032] Fishers exact test). Mean duration of follow-up was 21.9 weeks (SD = 4.1), range: 3-156 weeks.
Low flow priapism is common in our environment, and approximately half will occur in SCD patients who have had stuttering priapism previously. Timely diagnosis and treatment will reduce the probability of severe ED. In our experience, the Al-Ghorab shunt provides rapid relief. Enlightenment is vital in reducing ischemia time. Emphasis on preventive measures in SCD patients is vital.</description><identifier>ISSN: 1119-3077</identifier><identifier>DOI: 10.4103/1119-3077.175968</identifier><identifier>PMID: 26856282</identifier><language>eng</language><publisher>India: Medknow Publications and Media Pvt. Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Analysis ; Anemia, Sickle Cell - complications ; Anemia, Sickle Cell - epidemiology ; Anemia, Sickle Cell - physiopathology ; Diagnosis ; Erectile Dysfunction - epidemiology ; Erectile Dysfunction - etiology ; Erectile Dysfunction - physiopathology ; Humans ; Ischemia ; Ischemia - complications ; Male ; Middle Aged ; Nigeria ; Penis ; Priapism ; Priapism - epidemiology ; Priapism - etiology ; Retrospective Studies ; Young Adult</subject><ispartof>Nigerian journal of clinical practice, 2016-03, Vol.19 (2), p.207-211</ispartof><rights>COPYRIGHT 2016 Medknow Publications and Media Pvt. Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-e341b825ab75dfdb1a9e2f715f4f8df639e8d83f4bc21b753aead5e8f024013a3</citedby><cites>FETCH-LOGICAL-c397t-e341b825ab75dfdb1a9e2f715f4f8df639e8d83f4bc21b753aead5e8f024013a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26856282$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ugwumba, F O</creatorcontrib><creatorcontrib>Ekwedigwe, H C</creatorcontrib><creatorcontrib>Echetabu, K N</creatorcontrib><creatorcontrib>Okoh, A D</creatorcontrib><creatorcontrib>Nnabugwu, I</creatorcontrib><creatorcontrib>Ugwuidu, E S</creatorcontrib><title>Ischemic priapism in South-East Nigeria: Presentation, management challenges, and aftermath issues</title><title>Nigerian journal of clinical practice</title><addtitle>Niger J Clin Pract</addtitle><description>Ischemic priapism is the more common variety of priapism and often presents late. Outcome is largely dependent on the duration of ischemia.
To determine the etiology, presentation, management, and outcome of ischemic priapism.
Retrospective analysis of consecutive cases presenting to three hospitals offering specialist urological services in South-East Nigeria from January 2000 to December 2010.
Fifteen patients were assessed for clinical data and outcome.
The data were analyzed descriptively and inferentially using Statistical Package for Social Sciences (SPSS version 16, SPSS Inc., Chicago IL, USA) with P < 0.05.
Mean age was 30.5 years (standard deviation [SD] =1.63), range: 14-79 years. Onset to presentation interval ranged from 6 h to 28 days. Eight patients (53.3%) had sickle cell disease (SCD). Four patients (26.7%) had unidentified causes. The 8 SCD patients had stuttering priapism on several occasions previously. Six patients (40%) had taken oral herbal medications as treatment prior to presentation. Initial resuscitative measures were intravenous hydration, aspiration, and irrigation with normal saline in 13 patients. Glanulo-cavernous shunt (Al-Ghorab) was performed in all the patients. Detumescence was immediate in 14 and delayed in 1 patient. Three patients had transient recurrence of tumescence, while one had to be reshunted. Erectile dysfunction (ED) occurred in 7 patients (46.7%). Occurrence of ED increased significantly in patients presenting 24 h after onset of symptoms ([P = 0.032] Fishers exact test). Mean duration of follow-up was 21.9 weeks (SD = 4.1), range: 3-156 weeks.
Low flow priapism is common in our environment, and approximately half will occur in SCD patients who have had stuttering priapism previously. Timely diagnosis and treatment will reduce the probability of severe ED. In our experience, the Al-Ghorab shunt provides rapid relief. Enlightenment is vital in reducing ischemia time. Emphasis on preventive measures in SCD patients is vital.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Anemia, Sickle Cell - complications</subject><subject>Anemia, Sickle Cell - epidemiology</subject><subject>Anemia, Sickle Cell - physiopathology</subject><subject>Diagnosis</subject><subject>Erectile Dysfunction - epidemiology</subject><subject>Erectile Dysfunction - etiology</subject><subject>Erectile Dysfunction - physiopathology</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Ischemia - complications</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nigeria</subject><subject>Penis</subject><subject>Priapism</subject><subject>Priapism - epidemiology</subject><subject>Priapism - etiology</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>1119-3077</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkc1r1UAUxWeh2Frdu5IBQVw0z_lKMnFXSrWFooK6Hm6SOy8jyeSZO1n0v3fCq6UFmcXAmd-Zyz2HsTdS7IwU-qOUsim0qOudrMumss_Y6YN0wl4S_RaiarSVL9iJqmxZKatOWXtD3YBT6PhhCXAINPEQ-Y95TUNxBZT417DH_PKJf1-QMCZIYY7nfIIIe5yywLsBxhHjHumcQ-w5-ITLBGnggWhFesWeexgJX9_fZ-zX56ufl9fF7bcvN5cXt0WnmzoVqI1srSqhrcve962EBpWvZemNt72vdIO2t9qbtlMyMxoQ-hKtF8oIqUGfsQ_Hfw_L_CfPTW4K1OE4QsR5JSfryuQZRsmMvjuiexjRhejntEC34e7CGF2qWlYbtfsPlU-_BTZH9CHrTwzvHxkGhDENNI_rFhk9BcUR7JaZaEHvcvoTLHdOCre16bbq3FadO7aZLW_vt1vbCfsHw78q9V8-y5rG</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Ugwumba, F O</creator><creator>Ekwedigwe, H C</creator><creator>Echetabu, K N</creator><creator>Okoh, A D</creator><creator>Nnabugwu, I</creator><creator>Ugwuidu, E S</creator><general>Medknow Publications and Media Pvt. Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160301</creationdate><title>Ischemic priapism in South-East Nigeria: Presentation, management challenges, and aftermath issues</title><author>Ugwumba, F O ; Ekwedigwe, H C ; Echetabu, K N ; Okoh, A D ; Nnabugwu, I ; Ugwuidu, E S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-e341b825ab75dfdb1a9e2f715f4f8df639e8d83f4bc21b753aead5e8f024013a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Anemia, Sickle Cell - complications</topic><topic>Anemia, Sickle Cell - epidemiology</topic><topic>Anemia, Sickle Cell - physiopathology</topic><topic>Diagnosis</topic><topic>Erectile Dysfunction - epidemiology</topic><topic>Erectile Dysfunction - etiology</topic><topic>Erectile Dysfunction - physiopathology</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Ischemia - complications</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nigeria</topic><topic>Penis</topic><topic>Priapism</topic><topic>Priapism - epidemiology</topic><topic>Priapism - etiology</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ugwumba, F O</creatorcontrib><creatorcontrib>Ekwedigwe, H C</creatorcontrib><creatorcontrib>Echetabu, K N</creatorcontrib><creatorcontrib>Okoh, A D</creatorcontrib><creatorcontrib>Nnabugwu, I</creatorcontrib><creatorcontrib>Ugwuidu, E S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nigerian journal of clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ugwumba, F O</au><au>Ekwedigwe, H C</au><au>Echetabu, K N</au><au>Okoh, A D</au><au>Nnabugwu, I</au><au>Ugwuidu, E S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ischemic priapism in South-East Nigeria: Presentation, management challenges, and aftermath issues</atitle><jtitle>Nigerian journal of clinical practice</jtitle><addtitle>Niger J Clin Pract</addtitle><date>2016-03-01</date><risdate>2016</risdate><volume>19</volume><issue>2</issue><spage>207</spage><epage>211</epage><pages>207-211</pages><issn>1119-3077</issn><abstract>Ischemic priapism is the more common variety of priapism and often presents late. Outcome is largely dependent on the duration of ischemia.
To determine the etiology, presentation, management, and outcome of ischemic priapism.
Retrospective analysis of consecutive cases presenting to three hospitals offering specialist urological services in South-East Nigeria from January 2000 to December 2010.
Fifteen patients were assessed for clinical data and outcome.
The data were analyzed descriptively and inferentially using Statistical Package for Social Sciences (SPSS version 16, SPSS Inc., Chicago IL, USA) with P < 0.05.
Mean age was 30.5 years (standard deviation [SD] =1.63), range: 14-79 years. Onset to presentation interval ranged from 6 h to 28 days. Eight patients (53.3%) had sickle cell disease (SCD). Four patients (26.7%) had unidentified causes. The 8 SCD patients had stuttering priapism on several occasions previously. Six patients (40%) had taken oral herbal medications as treatment prior to presentation. Initial resuscitative measures were intravenous hydration, aspiration, and irrigation with normal saline in 13 patients. Glanulo-cavernous shunt (Al-Ghorab) was performed in all the patients. Detumescence was immediate in 14 and delayed in 1 patient. Three patients had transient recurrence of tumescence, while one had to be reshunted. Erectile dysfunction (ED) occurred in 7 patients (46.7%). Occurrence of ED increased significantly in patients presenting 24 h after onset of symptoms ([P = 0.032] Fishers exact test). Mean duration of follow-up was 21.9 weeks (SD = 4.1), range: 3-156 weeks.
Low flow priapism is common in our environment, and approximately half will occur in SCD patients who have had stuttering priapism previously. Timely diagnosis and treatment will reduce the probability of severe ED. In our experience, the Al-Ghorab shunt provides rapid relief. Enlightenment is vital in reducing ischemia time. Emphasis on preventive measures in SCD patients is vital.</abstract><cop>India</cop><pub>Medknow Publications and Media Pvt. Ltd</pub><pmid>26856282</pmid><doi>10.4103/1119-3077.175968</doi><tpages>5</tpages></addata></record> |
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| ispartof | Nigerian journal of clinical practice, 2016-03, Vol.19 (2), p.207-211 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; African Journals Online (Open Access) |
| subjects | Adolescent Adult Aged Analysis Anemia, Sickle Cell - complications Anemia, Sickle Cell - epidemiology Anemia, Sickle Cell - physiopathology Diagnosis Erectile Dysfunction - epidemiology Erectile Dysfunction - etiology Erectile Dysfunction - physiopathology Humans Ischemia Ischemia - complications Male Middle Aged Nigeria Penis Priapism Priapism - epidemiology Priapism - etiology Retrospective Studies Young Adult |
| title | Ischemic priapism in South-East Nigeria: Presentation, management challenges, and aftermath issues |
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