Elsevier

Urology

Volume 74, Issue 1, July 2009, Pages 113-115
Urology

Pediatric Case Report
Successful Treatment of Propofol-induced Priapism With Distal Glans to Corporal Cavernosal Shunt

https://doi.org/10.1016/j.urology.2008.12.066Get rights and content

We report a case of postoperative pediatric priapism in a boy without a hematologic disorder after a propofol-based general anesthetic. Our case underscores the importance of the early diagnosis and treatment to lessen the risk of complications. Given the wide use of propofol for sedation and anesthesia, clinicians should be cognizant of this rare, but serious, adverse effect that requires emergent attention.

Section snippets

Case Report

A 7-year-old white boy with severe spastic quadriplegia cerebral palsy was noted to have a penile erection in the recovery room after an uneventful extra digit excision of the right hand. The general anesthesia had consisted of propofol 70 mg for induction and 200 μg/kg/min for infusion, atropine 0.3 mg, fentanyl 50 μg, vecuronium 2 mg, ondansetron 2 mg, and Prostigmin (neostigmine bromide) 1 mg. The patient was discharged with instructions for parents to return if the erection did not resolve

Comment

Sickle cell disease alone accounts for nearly two thirds of all cases of pediatric priapism,6 with 28% of patients reporting an episode before 20 years of age.7 Priapism has also been reported in children with neurologic disorders such as spinal cord injury, transverse myelitis, and cerebrovascular disease1, 4, 6; however, it has not been associated with cerebral palsy. Other etiologies in children include antipsychotic medications,8, 9, 10 sildenafil citrate toxicity,11 Fabry's disease,12

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