Block T, Sturm W, Ernst G, Staehler G, Schmiedt E
Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Klinikum Grosshadern.
Urologe A. 1988 Jul;27(4):225-9.
A total of 19 patients (aged 17-66 years) with priapism received primarily conservative treatment in the form of aspiration of blood from the cavernous bodies and subsequent intracavernous (i.c.) administration of the alpha-adrenergic drug metaraminol. In 15 patients the priapism was due to i.c. injection of vasoactive agents; 1 patient each it had developed after hemodialysis, during oral prazosin medication, and in conjunction with Fabry's disease; and in 1 patient the etiopathogenesis was unknown. Treatment of priapism with metaraminol was successful in the first 15 patients and in 2 patients with priapism due to hemodialysis and oral prazosin medication. Therapy failed in long-lasting priapism associated with Fabry's disease and in priapism of unknown etiopathogenesis. Penile detumescence took place in the first 15 patients 3 min to 2.5 h after the injection of 2-4 mg metaraminol. Hemodialysis- and prazosin-linked priapism was treated with 5 and 2 mg metaraminol, respectively; in these patients erection subsided within 15 and 4 min after onset of therapy. In a further 2 patients in whom therapy had failed Al-Ghorab shunts were constructed, with the subsequent postoperative complication of erectile impotence. Injection of metaraminol must be carried out under strict supervision of the patient's circulatory system: doses of 4 mg metaraminol or more led to an increase in blood pressure and heart rate. In 15 patients with priapism induced by i.c. application of vasoactive agents, the analysis of blood gas parameters demonstrated a severe hypercapnia (70.3 +/- 10.0 mm Hg) and acidosis (pH 7.08 +/- 0.08) 5-10 h after the onset of erection, but severe hypoxia (37.0 +/- 16.6 mm Hg) was not found until erection had lasted for more than 10 h.(ABSTRACT TRUNCATED AT 250 WORDS)
共有19例阴茎异常勃起患者（年龄17 - 66岁）接受了以从海绵体抽血并随后海绵体内注射α - 肾上腺素能药物间羟胺为主的保守治疗。15例患者的阴茎异常勃起是由海绵体内注射血管活性药物引起；1例在血液透析后、1例在口服哌唑嗪药物期间、1例与法布里病相关出现阴茎异常勃起；1例患者的病因发病机制不明。间羟胺治疗阴茎异常勃起在最初15例患者以及2例因血液透析和口服哌唑嗪药物导致阴茎异常勃起的患者中取得成功。与法布里病相关的持续性阴茎异常勃起以及病因不明的阴茎异常勃起治疗失败。最初15例患者在注射2 - 4毫克间羟胺后3分钟至2.5小时阴茎消肿。血液透析和哌唑嗪相关的阴茎异常勃起分别用5毫克和2毫克间羟胺治疗；这些患者在治疗开始后15分钟和4分钟内勃起消退。另外2例治疗失败的患者进行了Al - Ghorab分流术，随后出现勃起功能障碍的术后并发症。间羟胺注射必须在严格监测患者循环系统的情况下进行：4毫克或更多剂量的间羟胺会导致血压和心率升高。在15例因海绵体内应用血管活性药物引起阴茎异常勃起的患者中，勃起开始后5 - 10小时血气参数分析显示严重高碳酸血症（70.3±10.0毫米汞柱）和酸中毒（pH值7.08±0.08），但直到勃起持续超过10小时才出现严重低氧血症（37.0±16.6毫米汞柱）。（摘要截取自250字）
