Resistant Priapism in Hemodialysis Patient: A Rare Case

Öz

Resistant Priapism in Hemodialysis Patient: A Rare Case

Öz

Introduction: Priapism is a penis erection that lasts longer than 4 hours without sexual stimulation and is a urological emergency that requires immediate treatment.Priapism can be seen rarely after hemodialysis.We aimed to present the patient with resistant priapism who underwent hemodialysis.Case Report: A 47-year-old man who underwent hemodialysis for two months due to end-stage renal disease admitted to the emergency department due to priapism.The penis was painful and rigid.Despite the drainaged of approximately 150 cc venous blood from corpus cavernosum with in 30 minutes,no detumescence was achieved.We performed a T-shunt combined with corporal tunneling.In the follow-up visits,the patient who was not able to have detumescence was informed and planned to have an early implantation of penile prosthesis due to necrosis, fibrosis,permanent loss of erection.Conclusion: Mechanism of priapism in hemodialysis patient is accused of inadequate heparinization and dialysis-induced hypoxemia and acidosis. First line treatment for ischemic priapism in emergency department is very important.The patient should be intervened quickly and directed to the urologist

Anahtar Kelimeler

• Priapism, hemodialysis, resistant priapism

Kaynakça

1. Salonia A, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Vardi Y, et al. European Association of Urology guidelines on priapism. Eur Urol 2014; 65: 480-9. [CrossRef]
2. Yücel ÖB, Salabaş E, Ermeç B, Kadıoğlu A. The case report of priapus and a modern approach to an ancient affliction. Sex Med Rev 2017; 5: 120-8. [CrossRef]
3. Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, et al. American Urological Association guideline on the manage- ment of priapism. J Urol 2003; 170: 1318-24. [CrossRef]
4. Kalathia J, Agrawal S, Chipde SS, Agrawal R. Homocysteinemia: A rare cause of priapism. Urol Ann 2016; 8: 118-21. [CrossRef]
5. Port FK, Fiegel P, Hecking E, Kohler H,Distler A. Priapism during regular haemodialysis. Lancet 1974; 2:1287-8. [CrossRef]
6. Fassbinder W, Frei U, Issantier R, Koch KM, Mion C, Shaldon S, et al. Fac- tors predisposing to priapism in haemodialysis patients. Proc Eur Dial Transplant Assoc 1976; 12: 380-6.
7. Singhal PC, Lynn RI, Scharschmidt LA. Priapism and dialysis. Am J Nephrol 1986; 6: 358-61. [CrossRef]
8. Bschleipfer TH, Hauck EW, Diemer TH, Bitzer M, Kirkpatrick Ch J, Pust RA, et al. Heparin-induced priapism. Int J Impot Res 2001; 13: 357-9. [CrossRef]

9. Kovac JR, Mak SK, Garcia MM, Lue TF. A pathophysiologybased ap- proach to the management of early priapism. Asian J Androl 2013; 15: 20-6. [CrossRef]
10. Sonmez MG, Sonmez LO, Taskapu HH, Kara C, Dundar ZD, Goger TE, et al. Etiological factors and management in priapism patients and at- titude of emergency physicians. Arch Ital Urol Androl 2017; 89: 203-7. [CrossRef]
11. Zacharakis E, Garaffa G, Raheem AA, Christopher AN, Muneer A, Ralph DJ. Penile prosthesis insertion in patients with refractory ischaemic priapism: early vs delayed implantation. BJU Int 2014; 114: 576-81. [CrossRef]