Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism

Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism

Alternative title Prevenção do priapismo recorrente com a utilização diária de inibidores da fosfodiesterase tipo 5
Author Nardozza Junior, Archimedes Autor UNIFESP Google Scholar
Cabrini, Marcelo Rodrigues Autor UNIFESP Google Scholar
Abstract Objective: The pathogenesis of recurrent priapism is currently being investigated based on the regulation of the phosphodiesterase 5 (PDE5) enzyme. We explored the daily use of PDE5 inhibitors to treat and prevent priapism recurrences. Method: We administered PDE5 inhibitors using a long-term therapeutic regimen in seven men with recurrent priapism, with a mean age of 29.2 years (range 21 to 35 years). Six men (85.7%) had idiopathic priapism recurrences and one man (24.3%) had sickle cell disease-associated priapism recurrences. Tadalafil 5 mg was administered daily. The mean follow-up was 6.6 months (range 3 to 12 months). Results: Daily long-term oral PDE5 inhibitor therapy alleviated priapism recurrences in all patients. Five (71.4%) had no episodes of priapism and two (28.6%) referred decrease in their episodes of priapism. All patients referred improvement in erectile function. Conclusion: These findings suggest the hypothesis that PDE5 dysregulation exerts a pathogenic role for both sickle cell disease-associated priapism and for idiopathic priapism, and that it offers a molecular target for the therapeutic management of priapism. These preliminary observations suggest that continuous long-term oral PDE5 inhibitor therapy may treat and prevent recurrent priapism.

Objetivo: Uma das teorias propostas para explicar a etiologia do priapismo recorrente está baseada no mecanismo de regulação da fosfodiesterase tipo 5. Estudamos o uso diário dos inibidores de fosfodiesterase tipo 5 no tratamento e na prevenção do priapismo recorrente. Método: Sete homens com diagnóstico de priapismo recorrente, com idade média de 29,5 anos (21 a 35 anos), utilizaram inibidor de fosfodiesterase tipo 5 em dose diária (tadalafila 5 mg/dia) por período prolongado. Seis homens (85,7%) apresentavam priapismo recorrente de etiologia idiopática, e um homem (24,3%), de etiologia associada à anemia falciforme. O seguimento médio foi de 6,6 meses (3 a 12 meses). Resultados: Todos os pacientes se beneficiaram com a utilização de inibidores de fosfodiesterase tipo 5. Cinco (71,4%) não apresentaram nenhum episódio de priapismo e dois (28,6%) relataram diminuição dos episódios. Todos os pacientes relataram melhora da função erétil. Conclusão: Estes achados sugerem que a hipótese do mecanismo de regulação da fosfodiesterase tipo 5 exerce papel importante na patogenia do priapismo recorrente. O uso contínuo e diário de inibidores da fosfodiesterase tipo 5 pode ser uma opção no tratamento do priapismo recorrente.
Keywords priapism
cyclic nucleotide phosphodiesterases type 5
erectile dysfunction
priapismo
fosfodiesterases nucleotídicas cíclicas tipo 5
disfunção erétil
Language English
Date 2017
Published in Revista Da Associacao Medica Brasileira. Sao Paulo, v. 63, n. 8, p. 689-692, 2017.
ISSN 0104-4230 (Sherpa/Romeo, impact factor)
Publisher Assoc Medica Brasileira
Extent 689-692
Origin http://dx.doi.org/10.1590/1806-9282.63.08.689
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000412280300005
SciELO ID S0104-42302017000800689 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/51412

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