Editing Priapism (section)

== Answers ==

# What is the definition of priapism? What are the subtypes?
#* Definition: a full or partial erection that continues > 4 hours beyond sexual stimulation and orgasm or is unrelated to sexual stimulation
#* Subtypes: ischemic, stuttering, non-ischemic
# What proportion of patients will recover erectile function for priapism reversed within a) 12 hours b) 12-24 hours c) 24-36 hours d) >36 hours
## 100%
## ≈80%
## ≈45%
## 0%
# After what duration of priapism is shunting no longer recommended?
#* >72 hours
# List risk factors for priapism.
# Which medications are associated with risk of priapism?
# What are the initial investigations in a patient with suspected priapism?
#* H+P, CBC, coagulation profile, blood gas, +/- urine toxicology screen, +/- sickle cell preparation and electrophoresis
# What is the expected PO2, PCO2, and pH of normal arterial gas vs. mixed venous gas vs. corporal aspirate from ischemic priapism?
#* Normal arterial blood gas: PO2 > 90, PCO2 <40, pH 7.4
#* Mixed venous gas: PO2 40, PCO2 50, pH 7.35
#* Ischemic priapism: PO2 < 30, PCO2 >60, pH < 7.25
# What is the maximum dose of phenylephrine that should be administered?
#* 2mg
# What are potential adverse effects related to phenylephrine injection?
## Headache
## Dizziness
## Hypertension
## Reflex bradycardia
## Tachycardia
## Irregular cardiac rhythms
# List and briefly describe the different shunting procedures
#* Distal
#** Percutaneous
#**# Winter
#**# Ebbehoj
#**# T-shunt
#** Open
#**# Al-Ghorab
#**# Corporal snake
#**# Combined T-shunt and Corporal Snake
#* Proximal
#*# Cavernosum-spongiosum
#*# Cavernosum-saphenous/deep dorsal vein
# What are potential complications of shunting?
#* Penile edema, hematoma, infection, urethral fistula, penile necrosis, and pulmonary embolism
# What are potential advantages to immediate implantation of prosthesis in the management of priapism?
## Corporal fibrosis not yet established
## Penile length may be preserved
# What medications can be used for prophylaxis in stuttering priapism?
## Phenylephrine
## Oral beta agonist
## PDE5 inhibitor
## GnRH or antiandrogens
## Intracavernosal alpha-agonist