1/6. Megalophallus as a sequela of priapism in sickle cell anemia: use of blood oxygen level-dependent magnetic resonance imaging.priapism is a common complication of sickle cell anemia. We report a little known sequela of priapism: painless megalophallus, with significant penile enlargement. The patient had had an intense episode of priapism 9 years previously and his penis remained enlarged. blood oxygen level-dependent magnetic resonance imaging revealed enlarged, hypoxic corpora cavernosa. Megalophallus probably resulted from permanent loss of elasticity of the tunica albuginea due to severe engorgement during the episode of priapism. This sequela needs to be recognized by physicians because no intervention is necessary and sexual function seems to remain intact.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
2/6. Fracture of the penis--diagnosis and management.Fracture of the penis is an uncommon injury, but it occurs most commonly during over enthusiastic sexual intercourse. diagnosis is not difficult but serious complications such as urethral rupture and corporo-urethral fistula may occur. Management should be by early surgical exploration, with evacuation of the haematoma and repair of the tear in the tunica albuginea in order to minimize the length of patient's stay in hospital and avoid complications such as penile deformity and painful penile erections.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
3/6. Sildenafil induced priapism.A 53 year-old Japanese man was referred to our hospital for persistent priapism, which had been induced by 200 mg (usual dose 25-50 mg) of sildenafil citrate (Viagra) three days earlier. He had a history of erectile dysfunction and had undergone penile injection therapy elsewhere; however, he had not used injection therapy this time. He obtained sildenafil personally without a doctor's prescription. He had not taken any other drugs that affect the metabolism of sildenafil, nor did he have any medical complications that might induce priapism. Since needle aspiration and irrigation were ineffective as first line therapy, surgical treatment was indicated to relieve the condition; a incision of tunica albuginea of both corpora cavernosa was made, and vigorous irrigation of saline washed out the blood clots. This is the first case report of priapism induced by sildenafil. Although this drug can be obtained through private commerce, it should be used under professional guidance as its abuse may lead to severe morbidity.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
4/6. Penile prostheses in the management of impotence in sickle cell disease.priapism lasting more than 24 h in adults with homozygous sickle cell disease usually results in impotence. The dense fibrosis of the corpora cavernosa which destroys the normal vascular erectile system of the penis also complicates insertion of penile prostheses. Our experience in 5 patients is reviewed. Sharp dissection and dilatation were necessary to form a tunnel for the prosthesis, which was more easily excavated anteriorly and posteriorly through a dorsal incision than for the length of the corpora through a traditional perineal-scrotal incision. Damage to the tunica was common and subsequent migration of the prosthesis necessitated an additional 11 procedures under general anaesthesia. Despite these technical difficulties, the procedure allowed satisfactory intercourse. The average interval between onset of impotence and implantation was 4 years. Early implantation before the dense fibrosis develops might give more satisfactory results.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
5/6. Marlex replacement of tunica albuginea.Prosthetic penile placement for management of impotence secondary to priapism often is difficult owing to scarring the corpus cavernosum. A patient with priapism treated with saline flush to allow detumescence had a proteus abscess of the corpus cavernosum requiring multiple debridement procedures. After healing Marlex was used to replace the debrided tunica albuginea and a Small-Carrion prosthesis was placed.- - - - - - - - - - ranking = 5keywords = tunica (Clic here for more details about this article) |
6/6. Corporeal fibrosis as a result of priapism prohibiting function of self-contained inflatable penile prosthesis.Corporeal fibrosis and erectile impotence are known sequelae of priapism. fibrosis following priapism may make subsequent placement of a penile prosthesis, especially inflatable devices, difficult or impossible. A case is described in which a self-contained inflatable prosthesis (Dynaflex) was successfully placed to treat impotence resulting from idiopathic priapism. However, fibrosis of the distal tunica albuginea of the corpora cavernosa rendered them noncompressible, and thus precluded inflation of the device with its distally placed pump mechanism. This anatomic problem is added to the list of potential contraindications to placement of self-contained inflatable penile prostheses, and the advisability of having patients who desire such a prosthesis also choose a secondary prosthesis type is emphasized.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |