title: Anticoagulant-induced priapism progressing to penile gangrene: a devastating complication!
abstract: A 35-year-old man developed priapism with the use of low-molecular-weight heparin and warfarin following repair of left brachial artery sustained after gunshot injury. Priapism progressed to penile gangrene despite decompression and distal shunt procedure leading to total penectomy and perineal urethrostomy. We describe the mechanism of anticoagulant (heparin and warfarin)-induced penile gangrene and the possible methods to avert such a devastating complication.
authors.affiliation: Department of Urology, Chhatrapati Shahuji Maharaj Medical University, Erstwhile King George Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Deepak Sharanappa
authors.initials: DS
authors.lastname: Nagathan
authors.forename: Harvinder Singh
authors.initials: HS
authors.lastname: Pahwa
authors.forename: Awanish
authors.initials: A
authors.lastname: Kumar
authors.forename: Apul
authors.initials: A
authors.lastname: Goel
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001916:Brachial Artery / Q000293:injuries / Q000601:surgery; D017985:Dalteparin / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005734:Gangrene; D006468:Hemopneumothorax / Q000601:surgery; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D010413:Penis / Q000473:pathology* / Q000601:surgery; D010502:Perineum / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000188:drug therapy; D011317:Priapism / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation; D013927:Thrombosis / Q000601:surgery; D018615:Ultrasonography, Doppler, Color; D014521:Urethra / Q000601:surgery; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use; D014948:Wounds, Gunshot / Q000601:surgery
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D017985:Dalteparin