PRIAPISM
This unfortunate condition may be humorous to everyone but the one who
is “blessed” with it. The common causes are few, and the mnemonic
MINT is an easy method for recall of these.
M—Malformation suggests phimosis and other deformities of the
penis.
I—Inflammationand intoxicationsuggest posterior
urethritis, prostatitis, and cystitis, as well as aphrodisiac drugs such as sildenafil citrate,
alcohol, cannabis, indica, camphor, and damiana.
N—Neoplasms suggest two common causes of priapism—chronic
lymphatic or myeloid leukemia and nasal polyps. The N also suggests
neurologic disorders such as neurosyphilis, multiple sclerosis, and
diabetic neuropathy.
T—Trauma recalls not only direct trauma to the penis producing a
local hematoma but also trauma to the spinal cord with fractures or
contusion.
Approach to the Diagnosis
The diagnosis of priapism usually depends on the association of other
symptoms and signs (e.g., boggy prostate), but a blood smear or bone marrow
examination may be necessary to exclude leukemia. A careful history of the
patient’s sexual activities to rule out too-frequent masturbation or sexual
excesses may be indicated.
Other Useful Tests
-
CBC (leukemia, sickle cell anemia)
-
Coagulation studies (blood dyscrasias)
-
Prostatic massage and examination of the discharge (prostatitis)
-
Urine culture (cystitis, pyelonephritis)
-
Serum protein electrophoresis (macroglobulinemia)
-
MRI of the brain (tumor, cerebrovascular accident [CVA],
multiple sclerosis)
-
MRI of spinal cord (multiple sclerosis, space-occupying lesion)
-
Spinal tap (multiple sclerosis, neurosyphilis)
-
Neurology consult
-
Urology consult
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
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- IMPOTENCE
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Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2008 Williams & Wilkins.
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