Paladino João Roberto, Wroclawski Marcelo, Den Julio Alexandre, Teixeira Gabriel Kushyama, Glina Sidney, Lima Pompeo Antonio Carlos
Department of Urology, ABC Medical School, Santo André, Brazil.
Can Urol Assoc J. 2014 Jul;8(7-8):E570-1. doi: 10.5489/cuaj.1774.
Priapism is a rare event that may be induced by clinical conditions and medications. Ischemic priapism (IP) is a compartment syndrome of the penis, and it constitutes a medical emergency that may cause significant morbidity on the erectile function in particular. We report a case of a 30-year-old male in his fourth episode of priapism. The aspiration and washing of the corpora cavernosa with saline solution were performed, followed by washing with adrenaline solution without resolution of the condition. Treatment was followed by the performance of the Al-Ghorab shunt procedure with dorsal incision of the glans. During follow-up, an area of necrosis distal to the incision was detected, and after the catheter removal on postoperative day 14, the patient developed a glandular dorsal urethrocutaneous fistula and meatal stenosis. The meatal stenosis was corrected by Johanson urethroplasty with a neo-meatus at the coronal sulcus, along with resection and debridement of the fistula tract and a three-layer closure.
阴茎异常勃起是一种罕见的情况,可能由临床病症和药物诱发。缺血性阴茎异常勃起(IP)是阴茎的一种骨筋膜室综合征,它构成一种医疗急症,尤其可能对勃起功能造成严重损害。我们报告一例30岁男性,这是他第四次出现阴茎异常勃起。对阴茎海绵体进行了生理盐水抽吸和冲洗,随后用肾上腺素溶液冲洗,但病情未缓解。治疗后进行了Al-Ghorab分流术,在龟头做背侧切口。在随访期间,在切口远端发现一处坏死区域,术后第14天拔除导管后,患者出现腺性背侧尿道皮肤瘘和尿道口狭窄。通过在冠状沟处做新尿道口的Johanson尿道成形术,以及瘘管切除和清创并进行三层缝合,纠正了尿道口狭窄。