Priapism is prolonged, and usually painful, erection not associated with sexual desire. It is a relatively rare acute urological disease where treatment must be started within 6 hours after its development, as after a longer time interval due to ischaemia irreversible fibrotic changes of the cavernous tissue of the penis develop which lead to permanent erectile dysfunction. There may be either low flow priapism (inadequate outflow of blood from the cavernous tissue) or more rarely high flow priapism (excessive inflow of blood). Priapism is classified with regard to its aetiology into primary (cause unknown) or secondary. The causes of secondary priapism are most frequently overdosage of vasodilatating agents during intracavernous injection treatment of erectile dysfunction (specially papaverine), tumours (obstruction of the efferent veins or direct infiltration of the corpora cavernosa)--in particular carcinoma of the urinary bladder, prostate and rectum. Priapism is frequently due to injuries of the prostate and straddle injuries. 5% men with sickle-cell anaemia suffer from an attack of priapism. Treatment of priapism differs, depending on the type, and should be entrusted to an experienced urologist in an in-patient department.
- MeSH
- lidé MeSH
- priapismus * diagnóza etiologie terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
The authors present a group of 304 adult patients (with the exception of one child with a Wilms tumour) from 1988-95 with the diagnosis of a primary renal tumour treated by surgery and subsequently subjected to histological examination. The tumours were in 83.9% clear renal cell tumours (Grawitz carcinoma), 4.3% were papillary carcinomas, 3.3% renal cortical adenomas, 3.9% oncocytomas and 2.0% non-differentiated carcinomas, 0.7% angiomyolipomas, 0.7% chromophobe cell renal carcinomas, 0.7% secondaries (carcinoma of the breast and testis), 0.7% multilocular cysts, one case each (0.3%) Wilms tumour, malignant lymphoma, necrotic histologically not classifiable tumour. The authors give a more detailed account of multilocular cystic RCC (which accounts for 5.9% Grawitz tumours), papillary tumours, chromophobe cell renal carcinoma, oncoytoma and angiomyolipoma. The authors correlate briefly the histological findings with preoperative graphic examinations. They are very sceptical as regards assessment of the histological type of tumour from preoperative graphic examination (with the exception of angiomyolipoma). Finally the authors suggest classification of renal expansions from the urologists aspect-in the first place from preoperative graphic examinations for non-neoplastic lesions (in particular cysts and hypertrophy of the columna Bertini), parenchymatous tumours and tumours of the renal pelvis and secondly (mainly in parenchymatous tumours) histological classification is taken into account.
