Effect of phenylephrine and terbutaline on ischemic priapism: a retrospective review.

BACKGROUND

Ischemic priapism is the most common cause of priapism due to low blood flow. Current guidelines recommend penile aspiration and the use of intracavernous injection of vasoactive agents. The data to support these recommendations are limited and rely on expert consensus.

OBJECTIVE

The objective was to determine the effectiveness of terbutaline and phenylephrine on detumescence of ischemic priapism.

METHODS

This was a retrospective review of patients presenting to the emergency department with a chief concern of priapism who received oral or subcutaneous terbutaline or intracavernous phenylephrine. The primary outcome is successful detumescence. The secondary outcome is drug-related adverse drug events.

RESULTS

A total of 31 cases of ischemic priapism were included, with 8 patients receiving terbutaline and 23 receiving phenylephrine. Of the cases treated with terbutaline, 25% had successful detumescence compared with phenylephrine with a 74% success rate. No drug-related adverse events were reported or identified.

CONCLUSIONS

Patients receiving intracavernous irrigation with phenylephrine were more likely to achieve successful detumescence than those treated with oral or subcutaneous terbutaline.