Bouchier-Hayes David, Nolan Philip, Pate Gordon
Urology, Galway Clinic, Doughiska, Ireland
Urology, Galway Clinic, Galway, Ireland.
BMJ Case Rep. 2021 Apr 1;14(4):e241897. doi: 10.1136/bcr-2021-241897.
This case report summarises the case of a 56-year-old man with low-flow, ischaemic priapism requiring urgent insertion of a penile prosthesis following prophylactic anticoagulation with tinzaparin. Low-molecular-weight heparin (LMWH) has been proposed as a cause of ischaemic priapism, although reported cases of this are rare. This particular side effect of tinzaparin has been reported once in a case report in 2018, and there are scant other reports of LMWH-induced priapism. This case was refractory to the full treatment algorithm, including multiple aspirations, phenylephrine injection, cavernosal shunt and required transfer for implantation of a penile prosthesis. Only one other case of such a severe case of priapism has been documented, involving LMWH and warfarin. Documented evidence of possible causes of priapism are vital, given the rarity of this condition, the frequency of LMWH and the potentially devastating complications.
本病例报告总结了一名56岁男性的病例，该患者在使用替扎肝素进行预防性抗凝后发生低流量缺血性阴茎异常勃起，需要紧急植入阴茎假体。低分子量肝素（LMWH）被认为是缺血性阴茎异常勃起的一个原因，尽管此类报道的病例很少。替扎肝素的这一特殊副作用在2018年的一篇病例报告中曾有过一次报道，关于LMWH诱导阴茎异常勃起的其他报道也很少。该病例对包括多次抽吸、去氧肾上腺素注射、海绵体分流在内的完整治疗方案均无效，需要转院植入阴茎假体。仅有另一例如此严重的阴茎异常勃起病例被记录在案，涉及LMWH和华法林。鉴于这种情况的罕见性、LMWH的使用频率以及潜在的毁灭性并发症，记录阴茎异常勃起可能原因的证据至关重要。
