Priapism in anesthesia for urological surgery: intrasurgical therapeutic alternatives

Abstract

Introduction:
Priapism can be defined as persistent erection over time and in the absence of sexual stimulus, it constitutes a
medical emergency, within its clinical etiology can be considered of two types: ischemic venous and nonischemic
arterial, being the first much more frequent. The occurrence of priapism within the intrasurgical
period is rare and can occur under both general and neuroaxial anesthesia, there is no florid literature on this
subject, so a clinical case presentation is made with updating of therapeutic alternatives for pharmacological
and anesthetics.

Objective: Describe a clinical case of priapism in anesthesia for urological surgery.

Material and methods: Retrospective descriptive study, clinical case presentation.

Results A clinical case of 33-year-old male patient diagnosed with left ureteral lithiasis programmed for
double catheter placement J, intracorporeal litotripsia and cystreteroscopy is described, who has permanent

penile erection that does not yield to anesthetic depth and muscle relaxation that make it impossible for the
surgical procedure due to difficulty in handling, responds appropriately to the administration of intracavernos
epinephrine, without evidence of adrenergic crisis or vascular commitment Distal.

Conclusions:
Intrasurgical priapism, not common, can occur by various etiologies (tactile stimulus, neuroaxial and general
anesthesia) can be caused by surgical suspensions not being treated promptly, appropriately and in a timely
manner. In the reality of our medium the inparaavernosal injection technique of 10 – 20 mcg of epinephrine is
a simple, easy method with immediate results that will allow penis manipulation for urological procedures.