פוסט זה זמין גם ב:
עברית
Guideline titles Priapism in People With and Without Sickle Cell Disease: Acute Diagnosis and Treatment
Release dates November 2021 and July 2022
Developer and funding source American Urological Association (AUA) and Sexual Medicine Society of North America (SMSNA)
Target population Males, including those with hematologic and oncologic disorders (eg, sickle cell disease [SCD]; chronic myelogenous leukemia [CML]) and those using intracavernosal vasoactive medications
Major recommendations
-
Clinicians should counsel patients with a priapism duration >36 hours that recovery of erectile function is unlikely (moderate recommendation; evidence level B).
-
Diagnostic testing should be done to determine the etiology of acute ischemic priapism (IP), but should not delay definitive treatment (expert opinion).
-
Penile corporal blood gas should be measured at presentation to distinguish IP from nonischemic priapism (NIP) (expert opinion).
-
First-line therapy for acute IP should be intracavernosal phenylephrine and corporal aspiration, with or without irrigation, before operative interventions (moderate recommendation; evidence level C).
-
A distal corporoglanular shunt procedure should be performed if acute IP persists after intracavernosal phenylephrine and corporal aspiration, with or without irrigation (moderate recommendation; evidence level C).
-
In patients with hematologic and oncologic disorders (eg, SCD, CML), standard management of acute IP should not be delayed for disease-specific systemic interventions (ie, exchange transfusion) (expert opinion).
