Tamsulosin-induced priapism: A case report
Year: 2024
Type: article
Study design: Case Report
Abstract: Background Priapism is a persistent erection generally lasting more than 4 h. Types of priapism include recurrent, ischemic, and non-ischemic and are generally classified based on penile arterial blood flow . Priapism can be induced by hematologic disorders (i.e. sickle cell anemia), infections, recreational drug use, and medication use. Tamsulosin is an α 1A receptor antagonist commonly used in the treatment of LUTS and benign prostatic hyperplasia (BPH). Case report We report a case of priapism lasting 48 hours due to tamsulosin. Aspiration and irrigation of the corpus cavernosa and intracavernosal injection of phenylephrine were performed without success. A penile blood gas revealed a pH of 6.92, pCO2 of 108 mmHg, pO2 of 40 mmHg, and HCO3 of 22.2 mmol/L—indicating ischemic priapism. A T-shunt was performed through the glans with moderate detumescence—the penis was able to bend at least 60° in all directions and 90° ventrally. The patient had a computed tomographic angiography (CTA) of the pelvis and a magnetic resonance angiography (MRA) 1 and 3 months later, respectively, which indicated proper flow and the absence of arteriovenous malformations . Why should an EM Physician be aware of this? Despite its attractive nature for the treatment of LUTS or BPH, because of α 1A receptor selectivity, tamsulosin should be recognized as a culprit of priapism. Because of the high affinity for the α 1A receptor, patients on tamsulosin may not respond to traditional medical therapies for priapism and therefore may require surgical intervention.
Source: JEM Reports
Authors: Julie Martino, Zane Elfessi, Heather Webster
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $700
OpenAlex ID: W4404131838