Departments of Urology.
Division of Hematology, Oncology & Bone Marrow Transplant, Department of Pediatrics, University of Wisconsin, Madison, Wisconsin.
Pediatrics. 2022 Jun 1;149(6). doi: 10.1542/peds.2021-054941.
Although rare in pediatrics, ischemic priapism carries significant risk of erectile dysfunction if not treated promptly. We report a case of idiopathic ischemic priapism in a male aged 14 years, refractory to traditional therapies, including aspiration/irrigation, phenylephrine injection, and distal shunt. However, the priapism resolved after intracavernosal injections of tissue plasminogen activator (tPA) with preservation of normal erectile function. To our knowledge, this is the first reported case of intracavernosal tPA for treatment of pediatric priapism. tPA may be a useful management option for recalcitrant ischemic priapism in pediatric patients and may prevent devastating outcomes such as lifelong erectile dysfunction.
虽然在儿科中罕见，但如果不及时治疗，缺血性阴茎异常勃起会导致显著的勃起功能障碍风险。我们报告了一例 14 岁男性特发性缺血性阴茎异常勃起病例，传统治疗方法（包括抽吸/冲洗、苯肾上腺素注射和远端分流）无效。然而，在进行阴茎海绵体内注射组织型纤溶酶原激活物（tPA）后，阴茎异常勃起得到缓解，同时保留了正常的勃起功能。据我们所知，这是首例报道的采用阴茎海绵体内注射 tPA 治疗儿童阴茎异常勃起的病例。tPA 可能是治疗儿童难治性缺血性阴茎异常勃起的一种有效治疗选择，并可预防如终身勃起功能障碍等灾难性后果。
