title: Resistant pediatric priapism: A real challenge for the urologist.
abstract: Priapism in pediatric patients is a rare entity. We present an 8-year-old boy with known cerebral palsy. He came to the emergency department with sustained painful erection for 12 hours. Physical examination showed rigid penis. Blood count and biochemical analysis were normal. Although penile Doppler ultrasound revealed normal arterial and venous flow, cavernosal blood gas was hypoxic. A total of 50 mL of dark blood was aspirated, and 2 mL of 0.001% adrenalin solution was applied to both corpus cavernosum, twice within 20 minutes, which eventually did not achieve detumescence. A distal Winter shunt was performed at the end of which the penis was semi-flaccid. By the 18th hour of surgery, the penis re-gained painful erection status, so an Al-Ghorab shunt was performed. After the Al-Ghorab shunt, the penis was still in the semi-flaccid state. The next day, an angiography was performed and an arteriovenous fistula was discovered and treated by embolization. The flaccid state was achieved and the patient was discharged the day after the embolization.
authors.affiliation: Marmara University, School of Medicine, Department of Urology, Turkey;
authors.forename: Cagri Akin
authors.initials: CA
authors.lastname: Sekerci
authors.affiliation: Marmara University, School of Medicine, Department of Urology, Turkey;
authors.forename: Cem
authors.initials: C
authors.lastname: Akbal
authors.affiliation: Marmara University, School of Medicine, Department of Urology, Turkey;
authors.forename: Tarik Emre
authors.initials: TE
authors.lastname: Sener
authors.affiliation: Marmara University, School of Medicine, Department of Urology, Turkey;
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahan
authors.affiliation: Marmara University, School of Medicine, Department of Urology, Turkey;
authors.forename: Bahadir
authors.initials: B
authors.lastname: Sahin
authors.affiliation: Marmara University, School of Medicine, Department of Radiology, Turkey.
authors.forename: Feyyaz
authors.initials: F
authors.lastname: Baltacioglu
authors.affiliation: Marmara University, School of Medicine, Department of Urology, Turkey;
authors.forename: Ferruh
authors.initials: F
authors.lastname: Simsek