Erkan ARSLAN, Hakan TÜRK, Eyyup Sabri PELİT

Priapizm Tedavisi: Tek Merkez Sonuçları

Amaç: Bu çalışmada amacımız bölgemizde priapizm nedeniyle acil servise veya üroloji kliniğine başvuran hastaların priapizm süresi, uygulanan tedavi, hastaların yaşı ve tedavi sonuçlarını değerlendirmektir.Materyal ve Metod: Ocak 2010 ile Mayıs 2018 tarihleri arasında priapizm nedeniyle başvuran 39 hasta çalışmaya dahil edildi. Tüm hastaların yaşı, priapizm tarihi, klinik öyküsü, priapizm nedenleri, intrakavernoz ilaç kullanımı, hastaneye başvuru süresi priapizm için yapılan tedavi ve sonuçları hasta dosyasından alındı.Bulgular: Toplam 39 hastada 43 priapizm epizodu görüldü. Hastaların yaş ortalaması 46,6 (27-70) yıl olarak tespit edildi. Hastaların tamamında intrakavernozal enjeksiyon kullanımı sonrasında priapizm geliştiği görüldü. Hastalar ortalama 22,6 (6-92) saat sonra tedavi için başvurduğu görüldü. Hastaların 9 (%23)’unda (10 epizod) erektil disfonksiyon şikayeti nedeniyle tedavi amaçlı kullanılan intrakavernozal enjeksiyon sonrası priapizm gelişti. 30 (%77) hasta da (33 epizod) ise penil dopler ultrason için yapılan intrakavernozal enjeksiyon sonrasında priapizm gelişti. 30 hasta (33 epizod) sadece drenaj ile tedaviden fayda görürken, 6 hastaya (9 epizod) drenaj+sempatomimetik uygulandı. Bu hastalardan ikisine priapizmin devam etmesi nedeniyle distal şant uygulanmıştır.Sonuç: Priapizm hastalarının çoğunluğunda drenaj yeterli olmaktadır. Ancak hasta başvuru süresinin uzaması ile drenaj yeterli olmamaktadır. Bu nedenle hastalar priapizm konusunda bilgilendirilmeli ve olası sonuçları paylaşılmalıdır.Anahtar kelimeler: Priapizm, Ürolojik Acil, Papaverin, Ağrı.

Anahtar Kelimeler:

Priapizm, ürolojik acil, papaverin, ağrı

Treatment of Priapism: A Single Center Experience

Background: The aim of this study was to evaluate patients in our region who applied to the emergency department or urology outpatient clinic due to priapism, regarding the parameters such as the duration of priapism, treatment, age, and treatment outcomes.Materials and Methods: Thirty-nine male patients who presented with priapism between January 2010 and May 2018 were included in the study. We reviewed all data in patients’ files and recorded patients’ data including age, date of first episode of priapism, duration as well as the clinical coarse of priapism, presence of accompanying conditions associated with priapism, history of intracavernosal injections use, administration of intracavernosal injections (self-administration or by a doctor), treatment method and outcomesResults: A total of 43 episodes of priapism were recorded in 39 patients. The mean age of the patients was 46.6 (27-70) years. It was observed that priapism developed following intracavernosal injections use in all patients. In 9 (23%) patients (10 episodes), priapism developed after intracavernosal injection, which was used for treatment due to erectile dysfunction and in 30 (77%) (33 episodes) patients following penile Doppler ultrasound with intracavernosal injections. 30 patients (32 episodes) were successfully treated with drainage only, while 9 patients (11 episodes) required drainage + sympathomimetic therapy, and two of these had distal shunt due to persistent priapism.Conclusions: Drainage is enough in the majority of priapism patients. However, drainage is not sufficient with the prolongation of the patient application period. In this regard, patients should be informed about potential risks before starting an ICI therapy.Key Words: Priapism, Urological emergency, Papaverine, Pain

Keywords:

Priapism, urological emergency, papaverine, pain,

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