Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Case report: ischemic priapism secondary to tinzaparin

International Journal of Impotence Research volume 30, pages 62–64 (2018)Cite this article

Subjects

Abstract

Low-molecular-weight heparin (LMWH) therapy has recently been proposed as a cause of ischemic priapism. The evidence, however, remains scarce, as there are very few published cases of LMWH-induced priapism to date. The implications of such events are significant as ischemic priapism is a medical emergency. In current clinical practice we are seeing a trend towards LMWH therapies replacing unfractionated heparin (UFH). As LMWH therapies continue to gain favor, we will potentially see more cases of LMWH-induced priapism. As such, consideration should be given to determine the underlying pathophysiology and incidence of LMWH-induced priapism. Herein, we present the case of a 33-year-old male with priapism in the setting of tinzaparin treatment.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Montague DK, Jarow J, Broderick GA, Dmochowski R, Heaton J, Lue T, et al. American Urological Association guideline on the management of priapism. J Urol. 2003;170:1318–24.

    Article  PubMed  Google Scholar 

  2. Kuefer R, Bartsch G, Herkommer K, Kramer SC, Kleinschmidt K, Volkmer BG. Changing diagnostic and therapeutic concepts in high-flow priapism. Int J Impot Res. 2005;17:109–13.

    Article  CAS  PubMed  Google Scholar 

  3. Salonia. A, Eardley I, Giuliano F, Hatzichristou D, Moncada Y, Vardi E, et al. European association of urology guidelines on priapism. Eur Urol. 2014;65:480–9.

    Article  PubMed  Google Scholar 

  4. Brichart N, Delavierre D, Peneau M, Ibrahim H, et al. Priapism associated with antipsychotic medications: a series of four patients. Prog Urol. 2008;18:669–73.

    Article  CAS  PubMed  Google Scholar 

  5. Brunett AL, Bivalacqua TJ. Priapism: current principles and practice. Urol Clin North Am. 2007;34:631–42.

    Article  Google Scholar 

  6. Kovac JR, Mark SK, Garcia MM, Lue TF. A physiology-based approach to the management of early priapism. Asian J Androl. 2013;15:20–6.

    Article  PubMed  Google Scholar 

  7. Basset J, Rajfer J. Diagnostic and therapeutic options for the management of ischemic and non-ischemic priapism. Rev Urol. 2010;12:56–63.

    Google Scholar 

  8. Burke BJ, Scott GL, Smith PJ, Wakerley GR. Heparin associated priapism. Postgrad Med J. 1983;59:332–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Duggan ML, Morgan C. Heparin: a cause of priapism? South Med J. 1970;63:1131–34.

    Article  CAS  PubMed  Google Scholar 

  10. Klein LA, Hall RL, Smith RB. Surgical treatment of priapism: with a note on heparin-induced priapism. J Urol. 1972;108:104–6.

    Article  CAS  PubMed  Google Scholar 

  11. Sale D, Cameron JS. Letter: Priapism during regular dialysis. Lancet. 1974;2:1567–68.

    Article  CAS  PubMed  Google Scholar 

  12. Bschleipfer TH, Hauck EW, Diemer TH, et al. Case report: heparin induced priapism. Int J Impot Res. 2001;13:357–9.

    Article  CAS  PubMed  Google Scholar 

  13. Clark SK, Tremann JA, Sennewald FR, Donaldon JA. Priapism: an unusual complication of heparin therapy for sudden deafness. Am J Otolaryngol. 1981;2:69–72.

    Article  CAS  PubMed  Google Scholar 

  14. Adjiman S, Fava P, Bitker MO, Chatelain C. Priapisme induit par I’he´parine—un prognostic plus sombre? Ann Urol. 1988;22:125–8.

    CAS  Google Scholar 

  15. De Siati M, Chierigo P, Contin F, Lazzarotto M, Franzolin N. Priapism as a complication of heparin therapy. Arch Ital Urol Androl. 1999;71:201–2.

    PubMed  Google Scholar 

  16. Routledge PA, Shetty HG, White JP, Collins P. Case studies in therapeutics: warfarin resistance and inefficacy in a man with recurrent thromboembolism, and anticoagulant-associated priapism. Br J Clin Pharmacol. 1998;46:343–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lin PH, Bush RL, Lumsden AB. Low molecular weight heparin induced priapism. J Urol. 2004;172:263.

    Article  PubMed  Google Scholar 

  18. Carmoi T, Skopinski S, Constans J, Vahedy A, Conri C. Priapism and low-molecular-weight heparin. Case report. Rev Med Intern. 2001;22:1002–3.

    Article  CAS  Google Scholar 

  19. Gong Z, Zhang Y, Chu H, Lian P, Zhang L, Sun P, et al. Priapism as the initial symptom of primary penile lymphoma: a case report. Oncol Lett. 2014;8:1929–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Madeb R, Rub R, Erlich N, Hegarty PK, et al. Longstanding priapism as presentation of lymphoma. Am J Hematol. 2007;82:87.

    Article  PubMed  Google Scholar 

  21. Kulmala RV, Lehtonen TA, Lindholm TS, Tammela TL. Permanent open shunt as a reason for impotence or reduced potency after surgical treatment of priapism in 26 patients. Int J Impot Res. 1995;7:175–80.

    CAS  PubMed  Google Scholar 

  22. McGowan KE, Makari J, Diamantouros A, Bucci C, Rempel P, Selby R, et al. Reducing the hospital burden of heparin-induced thrombocytopenia: impact of an avoid-heparin program. Blood. 2016;127:1954–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

No external resources/funding was provided to complete this research. This is original work with equal contributions from both authors.

Author information

Authors and Affiliations

  1. University of British Columbia, Prince George, Canada

    Jennifer Purnell

  2. Department of Urological Sciences, University of British Columbia, Suite 303 – 2155 10th Avenue, Prince George, BC, V2M5J6, Canada

    Alym N. Abdulla

Authors
  1. Jennifer Purnell
    View author publications

    Search author on:PubMed Google Scholar

  2. Alym N. Abdulla
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Alym N. Abdulla.

Ethics declarations

Competing interests

The authors declare that they have no competing financial interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Purnell, J., Abdulla, A.N. Case report: ischemic priapism secondary to tinzaparin. Int J Impot Res 30, 62–64 (2018). https://doi.org/10.1038/s41443-017-0008-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41443-017-0008-0

This article is cited by

Search

Advanced search

Quick links