Abstract
BackgroundRecurrent (stuttering) ischemic priapism is a challenging clinical condition. Frequent recurrences result in frequent hospital admissions whereas treatment with a shunting procedure often results in erectile dysfunction.Case presentationA 22-year-old man with stuttering idiopathic priapism developed erectile dysfunction (IIEF-5 score 12) following a Winter’s shunt; he was given tadalafil, 5 mg/daily, for 6 months. This treatment resulted in progressive restoration of erectile function in the 6 months following the shunt as well as in preventing recurrence of priapic episodes over a 24-month follow-up.ConclusionsThis is the first report in literature of chronic treatment of stuttering priapism with a phosphodiesterase-5 inhibitor being able not only to prevent recurrent priapic episodes but also to restore erectile function following a Winter’s shunt.
Highlights
Recurrent ischemic priapism is a challenging clinical condition
This is the first report in literature of chronic treatment of stuttering priapism with a phosphodiesterase-5 inhibitor being able to prevent recurrent priapic episodes and to restore erectile function following a Winter’s shunt
Recurrent priapism, commonly known as stuttering priapism, is an unusual form of low-flow priapism that usually results in cavernous ischemia with consequent damage of erectile function
Summary
Commonly known as stuttering priapism, is an unusual form of low-flow priapism that usually results in cavernous ischemia with consequent damage of erectile function. Intracavernous blood sampling was suggestive for hypoxic, low-flow priapism (Ph 7.00, PCO2 13, PO2 2.4) and again ICI of etilefrine 5 mg and corporeal irrigation/aspiration done twice did not lead to penile detumescence. He was admitted and scheduled for multiple (two for each corpus cavernosum) Winter’s shunts resulting in complete detumescence. At 9-months follow-up, the patient reported having resumed normal spontaneous and sexually-induced erections, with no episodes of prolonged erection nor of tadalafil use; did IIEF-5 score remain at 22 At 24-month follow-up he has normal spontaneous and sexually-induced erections without any drugs; IIEF-5 score remains 22
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