Re: HIGH FLOW PRIAPISM

Posted By HFHS M.D.-MS on March 06, 1998 at 16:22:05:

In Reply to: HIGH FLOW PRIAPISM posted by ESTEVES ALBERTO on March 03, 1998 at 22:07:43:








Happened to see a patient who I diagnosed of high flow priapism
It is a 7 year boy who fall in a boat.  His father noted a small equimosis lateral in the
right, on the base of the penis.  Some days latter noticed that the boy had
a persistent erection.
When I sow him, some two weeks later the boy had  a full erection, the penis
warm an no pain.
All the literature speaks about the therapeutic for this as selective
embolization of the cavernosal artery or the open procedure an ligation of the
artery.
What wuld be the optimal therapeutic option for a child this age.
Thak YOu
ALBERTO OMAR ESTEVES M.D.
LOS CEDROS 275  CUTRAL-CO
NEUQUEN 8322



          


Dear Dr. Alberto
Thank you for your question.
You may want to rule out other causes of correctable ischemic priapism. A CBC and sickle prep for completeness sake.  
The literature can not tell us what the best treatment option is for this patient with high flow priapism is  because it is difficult to get enough patients with this condition to study the natural history of no treatment verses surgical / radiological  treatment.  There may not be complications of following high flow priapism, but there are possible complications from surgery and embolization.  The best for this patient may be to follow this condition and elect repair when the  patient / family chooses.   There are social issues also, such as wearing a  bathing suit in public,  until this problem has been corrected.    There have been reports of patients refusing surgical repair that experienced  spontaneously resolution and had  resumption of normal  potency.   If there is  spontaneous resolution  without potency, a cavernosogram or doppler may direct the  surgical approach for correction.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568). We can also arrange local accommodations through this number if this is
your need. Please bring any physicians notes and lab test results that
you may be able to obtain. These will help us greatly.
Sincerely;
HFHS-M.D. MS
* Keyword: priapism, high flow priapism