Intracavernosal adrenalin injection in priapism

Prolonged erection is a rare problem in urology but it must be treated effe ctively. The most common etiological factor is intracavernosal vasoactive a gent injection for diagnosis or treatment of erectile dysfunction, The aim of this study was to evaluate the efficacy of intracavernosal adrenalin inj ection alone in the treatment of priapism. Nineteen patients with prolonged erection were evaluated. Seventeen out of the 19 prolonged erections were due to intracavernosal vasoactive agent injection and the remaining two wer e idiopathic. In all cases 2 ml adrenalin (1/100 000) was injected in each cavernosal body. In the patients who did not respond to the first injection , repeated adrenalin injections were performed at 20 min intervals. Blood p ressure and heart rate were monitored during the injections. Detumescence w as achieved in ten (53%) patients after the first injection. Repeated adren alin injections (2-5 injections) were required in nine patients and eight ( 42%) of them achieved detumescence, Only one (5%) patient who had 26-h prol onged erection could not achieve detumescence. There was no significant dif ference in blood pressure and heart rate during the monitoring of the patie nts when compared to the initial values. No standard treatment method has y et been described for prolonged erection, Repeated aspirations and irrigati ons for treatment of prolonged erection are problematical applications both for patients and urologist. Intracavernosal adrenalin injection alone can be used with high efficacy and safety for the treatment of prolonged erecti on especially in patients with a short duration of erection.