Table 1 Causes and physiopathology of ischemic priapism in older children and in adults
Cause | Percentage (%) | Physiopathology |
|---|---|---|
Haemoglobinopathy (Sick cell disease) | 65 | Microvascular obstruction for sickling of deoxygenates Haemoglobin S in small vessel with low pO2 [3, 15]. |
Leukaemia | 10 | Impairment of vascular integrity with activation of protrombotic mechanism for interaction of leukaemic blasts and endothelial cells [3]. |
Tumor (primary or metastatic) | 10 | Can lead to priapism through direct infiltration and obstruction [17, 45,46,47]. |
Drugs: Erectile dysfunction pharmacotherapies Antihypertensives (hydralazine, prazosin) Antipsychotics (chlorpromazine) Antidepressants (trazodone) Alcohol Cocaine | 5 | Vasoactive mechanisms [1]. |
Infection and central disease | Not reported | Action on central erectile centre or failure in detumescence mechanism [17]. |
Haemodialysis | Not reported | Hypovolemia and haemoconcentration who results in increase of intravascular viscosity [17, 48]. |
Parental nutrition | Not reported | It contains fat emulsion because this situation causes a rise of intravascular viscosity, stimulates blood coagulability and also it is possible the development of fat embolism [17, 49, 50]. |
Toxins (scorpion, spider) | Not reported | Action in Calcium and Potassium channels on the vascular smooth muscle cells [51]. |
Henoch –Schonlein purpura | Not reported | Obstruction to venous outflow [52]. |