Management of ischemic priapism in a 14 year old patient

Abstract

Priapism can occur in all age groups, including neonatales, children and adolescents. Pediatric priapism treatment is similar to adult priapism treatment, but there are no guidelines for the management of priapism, which is not common in children. We present a pediatric low-flow priapism case who was unresponsive to conservative methods and underwent T-shunt operation. In the present case, we wanted to emphasize when distal shunt surgery, which is rarely performed in pediatric patients, is necessary and how it is managed.

Keywords

• Pediatric ischemic priapism
• T-shunt surgery
• pediatric priapism case report

14 yaşındaki hastada iskemik priapizmin yönetimi

Abstract

Priapizm yenidoğan, çocuk ve ergenler de dahil olmak üzere tüm yaş gruplarında ortaya çıkabilir. Pediatrik priapizm tedavisi erişkin priapizm tedavisine benzer ancak çocuklarda yaygın olmayan priapizmin tedavisine yönelik bir kılavuz bulunmamaktadır. Konservatif yöntemlere yanıt vermeyen ve T-şant ameliyatı geçiren pediatrik düşük akımlı priapizm olgusunu sunmayı amaçladık. Bu olguda çocuk hastalarda nadiren uygulanan distal şant ameliyatının ne zaman gerekli olduğunu ve nasıl yönetildiğini vurgulamak istedik.

Keywords

• Pediatrik iskemik priapizm
• T-şant ameliyatı
• pediatric priapizm olgu sunumu

References

1. 1. Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R. Priapism: pathogenesis, epidemiology, and management. J Sex Med 2010;7:476-500. https://doi.org/10.1111/j.1743-6109.2009.01625.x
2. 2. Kulmala RV, Lehtonen TA, Tammela TL. Priapism, its incidence and seasonal distribution in Finland. Scand J Urol Nephrol 1995;29:93-96. https://doi.org/10.3109/00365599509180545
3. 3. Eland IA, van der Lei J, Stricker BH, Sturkenboom MJ. Incidence of priapism in the general population. Urology 2001;57:970-972. https://doi.org/10.1016/s0090-4295(01)00941-4
4. 4. Roghmann F, Becker A, Sammon JD, et al. Incidence of priapism in emergency departments in the United States. J Urol 2013;190:1275-1280. https://doi.org/10.1016/j.juro.2013.03.118
5. 5. Meijer B, Bakker HHR. Management of priapism in the newborn. Urology 2003;61:224. https://doi.org/10.1016/s0090-4295(02)02101-5
6. 6. Majeed S, Schor JA, Jacobson S, Jagoda A, Mahadeo R. Refractory priapism of unknown etiology in a pediatric patient. Pediatr Emerg Care 2000;16:347-351. https://doi.org/10.1097/00006565-200010000-00012
7. 7. Castagnetti M, Sainati L, Giona F, Varotto S, Carli M, Rigamonti W. Conservative management of priapism secondary to leukemia. Pediatr Blood Cancer 2008;51:420-423. https://doi.org/10.1002/pbc.21628
8. 8. De Jesus LE, Dekermacher S. Priapism in children: review of pathophysiology and treatment. J Pediatr (Rio J) 2009;85:194-200. https://doi.org/10.2223/JPED.1897

9. 9. Montague DK, Jarow J, Broderick GA, et al. American Urological Association guideline on the management of priapism. J Urol 2003;170:1318-1324. https://doi.org/10.1097/01.ju.0000087608.07371.ca
10. 10. Bastuba MD, de Tejada IS, Dinlenc CZ, Sarazen A, Krane RJ, Goldstein I. Arterial priapism: diagnosis, treatment and long-term followup. J Urol 1994;151:1231-1237. https://doi.org/10.1016/s0022-5347(17)35219-9
11. 11. Emir L, Tekgül S, Karabulut A, Oskay K, Erol D. Management of post-traumatic arterial priapism in children: presentation of a case and review of the literature. Int Urol Nephrol 2002;34:237-240. https://doi.org/10.1023/a:1023278616343
12. 12. Fuentes EJ, Garcia S, Garrido M, Lorenzo C, Iglesias JM, Sola JE. Successful treatment of propofol-induced priapism with distal glans to corporal cavernosal shunt. Urology 2009;74:113-115. https://doi.org/10.1016/j.urology.2008.12.066
13. 13. Dewan PA, Tan HL, Auldist AW, Moss DI. Priapism in childhood. Br J Urol 1989;64:541-545. https://doi.org/10.1111/j.1464-410x.1989.tb05295.x
14. 14. Sherrer R, Otto M, Srinivasan S, Grinde K, Farhat WA. Acute management of prolonged, recalcitrant priapism in a pediatric patient. Pediatrics 2022;149:e2021054941. https://doi.org/10.1542/peds.2021-054941
15. 15. Salabaş E, Kadıoğlu A. Priapizm tedavisinde şant teknikleri değişti mi? Turk Urol Sem 2011;2:303-308. 16. Salonia A, Eardley I, Giuliano F, et al. European association of urology guidelines on priapism. Eur Urol 2014;65:480-489. https://doi.org/10.1016/j.eururo.2013.11.008
16. 17. Brant WO, Garcia MM, Bella AJ, Chi T, Lue TF. T-shaped shunt and intracavernous tunneling for prolonged ischemic priapism. J Urol 2009;181:1699-1705. https://doi.org/10.1016/j.juro.2008.12.021
17. 18. Mercurio D, O'Donnell J. A case of non‐ischemic priapism in a healthy 7‐year‐old boy. J Am Coll Emerg Physicians Open 2022;3:e12785. https://doi.org/10.1002/emp2.12785
18. 19. Brönimann S, Thalhammer F, Springer A, Tonnhofer U, Shariat SF, D'Andrea D. Ischemic priapism in a 12 year old patient associated with coronavirus disease 2019 (COVID-19): a case report. Urology 2022;165:316-318. https://doi.org/10.1016/j.urology.2022.01.022