TY - JOUR
T1 - Conservative and medical treatments of non-sickle cell disease-related ischemic priapism
T2 - a systematic review by the EAU Sexual and Reproductive Health Panel
AU - Capogrosso, Paolo
AU - Dimitropolous, Kostas
AU - Russo, Giorgio Ivan
AU - Tharakan, Tharu
AU - Milenkovic, Uros
AU - Cocci, Andrea
AU - Boeri, Luca
AU - Gül, Murat
AU - Bettocchi, Carlo
AU - Carvalho, Joana
AU - Kalkanlı, Arif
AU - Corona, Giovanni
AU - Hatzichristodoulou, Georgios
AU - Jones, Hugh T.
AU - Kadioglu, Ates
AU - Martinez-Salamanca, Juan Ignacio
AU - Modgil, Vaibhav
AU - Serefoglu, Ege Can
AU - Verze, Paolo
AU - Salonia, Andrea
AU - Minhas, Suks
N1 - © 2022. The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/8/22
Y1 - 2022/8/22
N2 - Conservative and medical treatments are considered the first step in ischemic priapism (IP) management, although there is no clear evidence regarding their efficacy. We conducted a systematic review on behalf of the EAU Guidelines panel on Sexual and Reproductive health to analyse the available evidence on the efficacy and safety of conservative and medical treatment for non-sickle cell disease-related IP. Databases searched for relevant literature investigating efficacy and safety of conservative measures and medical treatment for IP included Medline, EMBASE, Cochrane Libraries and clinicaltrial.gov published up to September 2021. Overall, 41 retrospective, 3 prospective single-arm studies and 3 randomized controlled trials met the inclusion criteria. Intracavernous injection with sympathomimetic (ICIs) agents were the most frequently utilized treatment with efficacy ranging from 0 to 100% of cases. The combination of ICIs with corporeal aspiration with or without irrigation with saline was successful in 70 to 100% of cases. Oral treatment with β2 receptor agonist (e.g., terbutaline) showed mild to moderate efficacy. Conservative methods including ice pack, exercise, cold enema and ejaculation depicted lower effectiveness in resolving priapism (1–55%). Longer time interval from the onset to the resolution of IP was associated with higher rate of erectile dysfunction at follow-up (30–70%), especially after 24 h.
AB - Conservative and medical treatments are considered the first step in ischemic priapism (IP) management, although there is no clear evidence regarding their efficacy. We conducted a systematic review on behalf of the EAU Guidelines panel on Sexual and Reproductive health to analyse the available evidence on the efficacy and safety of conservative and medical treatment for non-sickle cell disease-related IP. Databases searched for relevant literature investigating efficacy and safety of conservative measures and medical treatment for IP included Medline, EMBASE, Cochrane Libraries and clinicaltrial.gov published up to September 2021. Overall, 41 retrospective, 3 prospective single-arm studies and 3 randomized controlled trials met the inclusion criteria. Intracavernous injection with sympathomimetic (ICIs) agents were the most frequently utilized treatment with efficacy ranging from 0 to 100% of cases. The combination of ICIs with corporeal aspiration with or without irrigation with saline was successful in 70 to 100% of cases. Oral treatment with β2 receptor agonist (e.g., terbutaline) showed mild to moderate efficacy. Conservative methods including ice pack, exercise, cold enema and ejaculation depicted lower effectiveness in resolving priapism (1–55%). Longer time interval from the onset to the resolution of IP was associated with higher rate of erectile dysfunction at follow-up (30–70%), especially after 24 h.
KW - Erectile Dysfunction
KW - Humans
KW - Male
KW - Priapism/etiology
KW - Prospective Studies
KW - Reproductive Health
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85136576130&partnerID=8YFLogxK
U2 - 10.1038/s41443-022-00592-2
DO - 10.1038/s41443-022-00592-2
M3 - Article
C2 - 35995858
AN - SCOPUS:85136576130
SN - 0955-9930
VL - 36
SP - 6
EP - 19
JO - International Journal of Impotence Research
JF - International Journal of Impotence Research
IS - 1
ER -