Priapism!!!

[ERNurse752]

I saw something interesting for the first time today...

We had a 34 y/o male present to the ED with an erection lasting greater than 24 hours, in a great deal of pain (the writhing and sweating kind!).

He had just started taking Trazadone for depression, and priapism can be caused by taking this drug.

First they tried SQ Terbutaline...didn't work. Then they tried Phenylephrine injected into the corpus callosum...also didn't work.

At that point the ER doc called in a urologist who decided he was going to take the pt. to surgery for an irrigation of the corpus callosum. At this point the pt. freaked out and signed out AMA, but he said that his erection was down about 80%. We couldn't convince him to stay and talk to the doc again, so we explained the risks of permanent penile damage, and told him to come back if he started having more pain, and/or if his erection returned. We were all pretty understanding that he was pretty scared of that surgery!

One of the risks of no treatment the urologist told us about was if the blood engorging the member just sat in there for too long, was the potential for the blood to clot in the member, cutting off circulation

I just thought that was interesting, so I thought I'd share it, and see if anyone else ever has!

[CATHYW]

I've only seen it once, in the ER, in the late 80's. A diabetic gentleman had had a penile implant (the pneumatic kind) the week before, and had been warned no hanky-panky. Apparently he and his wife could not resist, and there he was, engorged and tamponanded by the implant! The urologist tried several things (including epi) without result. When I left at 3, the man was headed to the OR. Never heard the "end" result.

[plumrn, BSN, RN]

I had a pt in his 60's,(looked older), who had priapism.This was

yrs ago so I don't remember all the details, but I do remember we had a pedi b/p cuff at the base of his member and we would inflate it every 15 mins to a certain pressure,then deflate it. We also applied ice I think.It eventually worked.Seems like there was something to do with amyl nitrate also..kind of fuzzy memory on that.This man laid there like he was asleep,never talking ( too embarassed), and I remember an odd thing; he had several family members stay with him and it was so strange to walk in there with all the relatives looking on,pull the covers back discreetly and do our thing, as they all looked on.

[GolfNut]

Wow these are scary stories....lol......glad not to be aflicted with ED

[claybob]

plumrn - when you say you pulled the covers back discreetly did you mean the family couldn't actually see the "problem"?

[suzy253, RN]

plumrn - when you say you pulled the covers back discreetly did you mean the family couldn't actually see the "problem"?

FYI--this posting was in 2001!

[THAT Nurse., MSN, RN, APRN]

Nothing like an old thread resurrection.

That said, I wonder, has anyone ever tried marathon sex as a cure? Think about it, normally it deflates after wards, at least a little. I know if I ever had it, I would sure try THAT solution!