2012, Number 3
Rev Mex Urol 2012; 72 (3)
Valladares-Coto BA, Téllez-Arce G, Beas-Luna A, Alfaro-Robles E, Manzo-Pérez BO, Gómez-Radillo FE, Varela-Figueroa D, Morales-Fonseca JC, Chávez-Solis EA, Gallo-Ochoa M
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ABSTRACTPriapism is defined as the painful erection of the penis that lasts for more than four hours and that is not associated with sexual stimulation. Depending on its etiology, priapism can be classified as low-flow (ischemic), highflow (nonischemic) and intermittent. Low-flow priapism has been associated with hematologic diseases, neoplastic processes, psychotropic drugs such as phenothiazines and trazodone, antihypertensive agents such as prazosin, as well as with hemodialysis, heparin, and parenteral nutrition. Low-flow priapism is considered to be a urologic emergency because it behaves like compartment syndrome with necrosis and fibrosis of the cavernous tissue, leading to erectile dysfunction. These complications present in relation to the length of time of progression and treatment aggression and this is why different medical and surgical managements are currently described for achieving penile detumescence. The case is presented of a patient diagnosed with difficult-to-manage low-flow priapism associated with prazosin ingestion that underwent Quackels cavernosumspongiosum shunt as definitive detumescence treatment.