Priapism: Difference between revisions
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====== Technique<span style="color:#ff0000">[https://pubmed.ncbi.nlm.nih.gov/35536142/ ★]</span> ====== | ====== Technique<span style="color:#ff0000">[https://pubmed.ncbi.nlm.nih.gov/35536142/ ★]</span> ====== | ||
*The optimal regimen for phenylephrine dosing, frequency, and method of administration has not been clearly defined | *The optimal regimen for phenylephrine dosing, frequency, and method of administration has not been clearly defined | ||
** '''Phenylephrine diluted in normal saline to a concentration of 100-500 mcg/mL''' (0.1-0.5 mg/mL) (optimally premixed by pharmacy to minimize risks of miscalculation/overdose) | ** '''<span style="color:#ff0000">Phenylephrine diluted in normal saline to a concentration of 100-500 mcg/mL</span>''' (0.1-0.5 mg/mL) (optimally premixed by pharmacy to minimize risks of miscalculation/overdose) | ||
** | ***Dilute 10mg/mL vial of phenylephrine with 19mL of normal saline to get 10mg/20mL volume = 0.5mg/mL = 500mcg/mL | ||
** '''Administered intracavernosally (not subcutaneously)''' | ** '''Administered intracavernosally (not subcutaneously)''' | ||
** '''Administered laterally (3 or 9 o’clock position) near the base of the penile shaft''' | ** '''Administered laterally (3 or 9 o’clock position) near the base of the penile shaft''' | ||
*** Small needles may be used (e.g., 27G) if not aspirating | *** Small needles may be used (e.g., 27G) if not aspirating | ||
** '''<span style="color:#ff0000">May be continued for up to 1 hour''' | ** '''<span style="color:#ff0000">Doses administered ≥5 minutes apart''' | ||
**'''<span style="color:#ff0000">May be continued for up to 1 hour''' | |||
*** '''<span style="color:#ff0000">If the erection persists despite repeated attempts with injections and aspiration/irrigation > 1 hour, proceed with more definitive therapy (i.e., shunting procedure).''' | *** '''<span style="color:#ff0000">If the erection persists despite repeated attempts with injections and aspiration/irrigation > 1 hour, proceed with more definitive therapy (i.e., shunting procedure).''' | ||
** '''In cases where the combination of phenylephrine and aspiration/irrigation are performed, aspiration should precede phenylephrine administration to permit fresh, oxygenated blood to fill the corpora and potentially improve the yield of phenylephrine administration''' | ** '''In cases where the combination of phenylephrine and aspiration/irrigation are performed, aspiration should precede phenylephrine administration to permit fresh, oxygenated blood to fill the corpora and potentially improve the yield of phenylephrine administration''' | ||