Priapism presenting in acute spinal cord injury
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 1645-1654
Abstract
Background: The frequency and timing of priapism in acute spinal cord injury (SCI) and the level, or levels, most likely to be associated with priapism are debated.A spinal cord injury (SCI) is defined as damage to the spinal cord caused by an insult resulting in the transient or permanent loss of usual spinal motor, sensory, and autonomic function.
Methods: This is prospective observational study done in PES Institute of Medical Sciences, Kuppam, from February 2019 to February 2020. A total of 15 cases were studied. The patients selected for study are those who presented with history of cervical /thoracic spine injury with complete neurological deficits, following trauma. Based on detailed history and thorough clinical examination diagnosis of priapism in spinal cord injury was made. Investigations done: Complete Blood counts, Blood grouping, Coagulation profile Peripheral Smear, Renal function tests, Serology, Corporeal Blood gas analysis, CT Cervical/thoracic spine, MRI cervical spine with whole spine screening.
Results: A total of 15 patients who presented with spinal column injuries with neurological deficits Quadriplegia or paraplegia, following trauma were included in the present study. Eleven of the 15 patients had priapism. Four out of the 15 patients presented with quadriplegia but without priapism. Among the 11 patients, 4 patients presented with Paraplegia with priapism secondary to complete cord transection of the lower cervical/high thoracic cord. Seven patients presented with quadriplegia and priapism secondary to complete cord transection of the cervical cord. All 15 patients underwent spine stabilization surgery along with surgical decompression of the spinal canal and conservative management for priapism. In 6 patients, the priapism subsided spontaneously within 12hours, in two pts it subsided within 24hrs for in two pts it lasted for 36 hours while in one patient it lasted for 4 days post spinal canal decompression.
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