Ugwumba F O, Ekwedigwe H C, Echetabu K N, Okoh A D, Nnabugwu I, Ugwuidu E S
Department of Surgery, Urology Unit, Faculty of Medical Sciences, University of Nigeria and University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria.
Niger J Clin Pract. 2016 Mar-Apr;19(2):207-11. doi: 10.4103/1119-3077.175968.
Ischemic priapism is the more common variety of priapism and often presents late. Outcome is largely dependent on the duration of ischemia.
To determine the etiology, presentation, management, and outcome of ischemic priapism.
Retrospective analysis of consecutive cases presenting to three hospitals offering specialist urological services in South-East Nigeria from January 2000 to December 2010.
Fifteen patients were assessed for clinical data and outcome.
The data were analyzed descriptively and inferentially using Statistical Package for Social Sciences (SPSS version 16, SPSS Inc., Chicago IL, USA) with P < 0.05.
Mean age was 30.5 years (standard deviation [SD] =1.63), range: 14-79 years. Onset to presentation interval ranged from 6 h to 28 days. Eight patients (53.3%) had sickle cell disease (SCD). Four patients (26.7%) had unidentified causes. The 8 SCD patients had stuttering priapism on several occasions previously. Six patients (40%) had taken oral herbal medications as treatment prior to presentation. Initial resuscitative measures were intravenous hydration, aspiration, and irrigation with normal saline in 13 patients. Glanulo-cavernous shunt (Al-Ghorab) was performed in all the patients. Detumescence was immediate in 14 and delayed in 1 patient. Three patients had transient recurrence of tumescence, while one had to be reshunted. Erectile dysfunction (ED) occurred in 7 patients (46.7%). Occurrence of ED increased significantly in patients presenting 24 h after onset of symptoms ([P = 0.032] Fishers exact test). Mean duration of follow-up was 21.9 weeks (SD = 4.1), range: 3-156 weeks.
Low flow priapism is common in our environment, and approximately half will occur in SCD patients who have had stuttering priapism previously. Timely diagnosis and treatment will reduce the probability of severe ED. In our experience, the Al-Ghorab shunt provides rapid relief. Enlightenment is vital in reducing ischemia time. Emphasis on preventive measures in SCD patients is vital.
缺血性阴茎异常勃起是阴茎异常勃起中较常见的类型，且常出现较晚。其预后很大程度上取决于缺血持续时间。
确定缺血性阴茎异常勃起的病因、表现、治疗及预后。
对2000年1月至2010年12月在尼日利亚东南部提供专科泌尿外科服务的三家医院连续收治的病例进行回顾性分析。
对15例患者的临床资料及预后进行评估。
使用社会科学统计软件包（SPSS 16版，SPSS公司，美国伊利诺伊州芝加哥）对数据进行描述性和推断性分析，P<0.05。
平均年龄为30.5岁（标准差[SD]=1.63），范围为14 - 79岁。发病至就诊间隔时间为6小时至28天。8例患者（53.3%）患有镰状细胞病（SCD）。4例患者（26.7%）病因不明。8例SCD患者之前曾多次出现间歇性阴茎异常勃起。6例患者（40%）在就诊前曾服用口服草药进行治疗。13例患者的初始复苏措施为静脉补液、穿刺抽吸及用生理盐水冲洗。所有患者均进行了阴茎头海绵体分流术（Al - Ghorab术）。14例患者阴茎消肿迅速，1例延迟。3例患者出现短暂性肿胀复发，1例患者需再次进行分流术。7例患者（46.7%）出现勃起功能障碍（ED）。症状发作后24小时就诊的患者中ED的发生率显著增加（[P = 0.032] Fisher精确检验）。平均随访时间为21.9周（SD = 4.1），范围为3 - 156周。
低流量型阴茎异常勃起在我们的环境中很常见，约一半发生在之前有间歇性阴茎异常勃起的SCD患者中。及时诊断和治疗将降低严重ED的可能性。根据我们的经验，Al - Ghorab分流术能迅速缓解症状。提高认识对于缩短缺血时间至关重要。对SCD患者强调预防措施至关重要。
