Priapism is a persistent, unwanted erec tion that is not associated with sexual desire or sexual stimulation. There are three types of priapism; ischemic priapism, non-ischemic priapism and recurrent (stuttering) priapism. Ischemic priapism can cause injury to cavernous tissue; and therefore needs emergent evaluation and treatment. Aspiration and irrigation of corpus cavernosum is successful if erection lasts <24 h.[1] In the case reported, the patient had an erection lasting ~5 days. A distal cavernoglanular shunt, which the authors performed, should be the first choice in such cases.
Pregabalin is an anticonvulsant used in treatment of neuropathic pain, fibromyalgia and certain subtypes of seizures. The authors report the first case of priapism associated with pregabalin. In an animal study, pregabalin decreased the expression of neuronal nitric oxide synthase (nNOS and endothelial NOS).[2] Decrease in nitric oxide synthesis leads to tumescence and not erection. Hence, it is plausible that priapism could have been idiopathic.
REFERENCES
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