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- Title
Homocysteinemia: A rare cause of priapism.
- Authors
Kalathia, Jaisukh; Agrawal, Santosh; Chipde, Saurabh Sudhir; Agrawal, Rajeev
- Abstract
Priaprism is a persistent painful erection that continuous beyond or is unrelated to sexual stimulation. Majority of cases are idiopathic (46%), alcohol and drug related (21%), perineal trauma (12%), sickle cell anemia and hypercoagualable state related (11%). We report case of priapism caused by hyperhomocysteinemia with favorable outcome with only few cases so far reported in the literature to the best of our knowledge. A 31 year-old male referred to our institution with non resolving priaprism for the last 6 days. Immediate distal shunt (Al-ghorab) was created but it could not achieve the detumescence. The penile Doppler showed no flow into the corpora, so a proximal shunt (Quackels) was made which achieved satisfactory detumescence. On thorough evaluation for the cause of priaprism, only homocysteine level was found to be significantly raised (40.46 µmol/L), being the unusual and rare cause for priaprism. The patient was discharged on homocheck. In the follow-up the patient is on vacuum assisted device for the erectile dysfunction and has been advised for the penile implant. Priaprism being a urological emergency should be thoroughly evaluated even for the rare causes and should be timely intervened to avoid the unavoidable consequences of permanent erectile dysfunction.
- Subjects
PENILE erection; HYPERHOMOCYSTEINEMIA; SURGICAL anastomosis; HOMOCYSTEINE
- Publication
Urology Annals, 2016, Vol 8, Issue 1, p118
- ISSN
0974-7796
- Publication type
Case Study
- DOI
10.4103/0974-7796.171497