European Association of Urology Guidelines on Priapism
European Association of Urology Guidelines on Priapism
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DOI：
10.1016/j.eururo.2013.11.008
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发表时间：
2014-02-01
期刊：
影响因子：
23.4
通讯作者：
Hatzimouratidis, Konstantinos
中科院分区：
文献类型：
--
作者：
Salonia, Andrea;Eardley, Ian;Hatzimouratidis, Konstantinos
背景：阴茎异常勃起被定义为阴茎勃起持续超过性兴趣或刺激或与性兴趣或刺激无关。它可以分为缺血性（低流量），动脉（高流量），或口吃（复发性或间歇性）。目的：为阴茎异常勃起的诊断和治疗提供指导方针。证据采集：阴茎异常勃起的流行病学，诊断和治疗的系统文献检索。选择最高证据的文章作为这些建议的基础。证据综合：缺血性阴茎异常勃起通常是特发性的，也是最常见的形式。动脉性阴茎异常勃起通常发生在会阴钝伤后。病史是诊断的主要依据，有助于确定发病机制。实验室检测用于支持临床结果。缺血性阴茎异常勃起是一种紧急情况。干预应在4-6小时内开始，包括通过抽吸和海绵体内注射拟交感神经药物（例如，G.苯乙醯胺）。保守治疗失败者建议手术治疗，但最佳方法尚不清楚。对于长期持续的阴茎异常勃起，应考虑立即植入假体。动脉性阴茎异常勃起不是急症。选择性栓塞是推荐的治疗方式，成功率高。口吃性阴茎异常勃起知之甚少，主要的治疗目标是预防未来的发作。这可能是实现的，但疗效的数据是limited.Conclusions：这些指南总结了目前的信息阴茎异常勃起。扩展版可在欧洲泌尿外科协会网站（www.uroweb.org/guidelines/）上获得。患者摘要：阴茎异常勃起是一种持续性的，通常是疼痛的，阴茎勃起持续超过4小时，与性刺激无关。它在镰状细胞病患者中更常见。本文介绍了缩短EAU阴茎异常勃起指南，基于系统的文献综述。阴茎异常勃起的病例分为缺血性（低流量）、动脉性（高流量）或口吃（复发性）。治疗缺血性阴茎异常勃起必须及时，以避免永久性勃起功能障碍的风险。动脉性阴茎异常勃起的情况并非如此。(C)2013年欧洲泌尿外科协会。由Elsevier B出版。V.保留所有权利。
Context: Priapism is defined as a penile erection that persists beyond or is unrelated to sexual interest or stimulation. It can be classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent or intermittent).Objective: To provide guidelines on the diagnosis and treatment of priapism.Evidence acquisition: Systematic literature search on the epidemiology, diagnosis, and treatment of priapism. Articles with highest evidence available were selected to form the basis of these recommendations.Evidence synthesis: Ischaemic priapism is usually idiopathic and the most common form. Arterial priapism usually occurs after blunt perineal trauma. History is the mainstay of diagnosis and helps determine the pathogenesis. Laboratory testing is used to support clinical findings. Ischaemic priapism is an emergency condition. Intervention should start within 4-6 h, including decompression of the corpora cavernosa by aspiration and intracavernous injection of sympathomimetic drugs (e. g. phenylephrine). Surgical treatment is recommended for failed conservative management, although the best procedure is unclear. Immediate implantation of a prosthesis should be considered for long-lasting priapism. Arterial priapism is not an emergency. Selective embolization is the suggested treatment modality and has high success rates. Stuttering priapism is poorly understood and the main therapeutic goal is the prevention of future episodes. This may be achieved pharmacologically, but data on efficacy are limited.Conclusions: These guidelines summarise current information on priapism. The extended version are available on the European Association of Urology Website (www.uroweb.org/guidelines/).Patient summary: Priapism is a persistent, often painful, penile erection lasting more than 4 h unrelated to sexual stimulation. It is more common in patients with sickle cell disease. This article represents the shortened EAU priapism guidelines, based on a systematic literature review. Cases of priapism are classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent). Treatment for ischaemic priapism must be prompt in order to avoid the risk of permanent erectile dysfunction. This is not the case for arterial priapism. (C) 2013 European Association of Urology. Published by Elsevier B. V. All rights reserved.