Chlorpromazine induced priapism : An up to date mini-review

Abstract

Ischemic priapism is considered as the most common type of priapism (accounting for >95% of cases) that is due to obstruction of venous outflows from leading to impaired perfusion of cavernous tissue with subsequent hypoxia, hypercapnia and acidosis, ending in fibrosis and erectile dysfunction. Several causes have been attributed to cause ischemic priapism including hemoglobinopathies (including sickle cell anemia and thalassemias), hypercoagulable status, neoplastic syndromes, compressive pelvi-abdominal masses, and spinal cord injuries. In addition, the use of some drugs may lead to iatrogenic veno-occlusive priapism including use of some recreational drugs (cocaine, heroin, opiates, and cannabis) and medications (intracavernosal injections of papaverine, phentolamine, and prostaglandin E1, anticoagulants, α-blockers, antidepressants, and antipsychotics). However, ischemic priapism has been identified as idiopathic in most cases as no specific cause could be identified. Urgent management of ischemic priapism with aspiration/ irrigation along with the use of sympathomimetic agents gives better outcome. However, if left untreated, resolution may take days and erectile dysfunction invariably results that may require penile prosthesis implantation [2].