James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
BJU Int. 2021 May;127(5):498-506. doi: 10.1111/bju.15370. Epub 2021 Mar 28.
To examine the current molecular therapeutics in the medical treatment of recurrent ischemic priapism (RIP). To propose a stepwise clinical management paradigm for the treatment of RIP.
We performed a literature search using the PubMed database for the terms 'recurrent ischemic priapism' and 'stuttering priapism' up until December 2020. We assessed pre-clinical and clinical studies regarding medical management of RIP and molecular pathophysiology. Case series and randomized trials were evaluated by study quality and patient outcomes to determine a potential clinical management scheme.
Recent research has fostered an improved understanding of the underlying molecular pathophysiology of RIP that has paved the way forward for developing new therapeutic agents. Medications targeting neurovascular, hormonal and haematological mechanisms associated with RIP show great promise towards remedying this condition. A host of therapeutic agents operating across different mechanistic directions may be implemented according to a clinical management scheme to potentially optimize RIP outcomes.
RIP remains a medically neglected condition with current management focused on treating the acute condition rather than modulating the course of disease. Continued research into the molecular mechanisms of RIP and standardized clinical pathways can improve the quality of care for patients suffering from this condition.
研究目前在复发性缺血性阴茎异常勃起（RIP）治疗中的分子治疗方法。为 RIP 的治疗提出一个逐步的临床管理范例。
我们使用 PubMed 数据库对截至 2020 年 12 月的“复发性缺血性阴茎异常勃起”和“间歇性阴茎异常勃起”这两个术语进行了文献检索。我们评估了有关 RIP 的医学治疗和分子病理生理学的临床前和临床研究。通过研究质量和患者结局评估病例系列和随机试验，以确定潜在的临床管理方案。
最近的研究促进了对 RIP 潜在分子病理生理学的更好理解，为开发新的治疗剂铺平了道路。针对与 RIP 相关的神经血管、激素和血液学机制的药物在治疗这种疾病方面显示出巨大的希望。根据临床管理方案，可以实施一系列作用于不同机制方向的治疗药物，以潜在地优化 RIP 的结局。
RIP 仍然是一种被医学忽视的疾病，目前的治疗重点是治疗急性疾病，而不是调节疾病进程。对 RIP 的分子机制和标准化临床路径的持续研究可以提高患有这种疾病的患者的护理质量。
