Tamsulosin in a widely used drug in urology practice in treating lower urinary tract symptoms of benign prostatic hyperplasia, distal ureteral stones, and ureteral stent-related symptoms. Ischemic priapism is a rare but serious adverse effect of tamsulosin. We report two cases of tamsulosin-induced priapism and reviewed available literature citing priapism as a complication of tamsulosin. We also reviewed the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database to identify reported cases of tamsulosin-induced priapism. First patient was a 61-year-old African American male with paraplegia of 30-year duration. He developed priapism after taking first dose of tamsulosin for lower urinary tract symptoms. He presented with 18 hours of painful erection and was treated with aspiration and irrigation, followed by phenylephrine injection. The patient maintained potency after treatment. The second patient was a 24-year-old male who received tamsulosin in the emergency department as medical expulsive therapy for 11 mm distal ureteral stone. Since he had intractable pain, he underwent emergency primary ureteroscopy with laser lithotripsy as definitive treatment of his ureteral calculus. He developed intraoperative priapism that subsided postoperatively. However, he was discharged with tamsulosin to reduce stent-related urinary symptoms. He returned back to the emergency department after 3 days with persistent priapism for 3 days and needed penoscrotal corporeal decompression to treat his priapism. At 6 weeks follow-up visit, the patient has lost his potency. Although there were only 4 case reports on review of the literature, we were able to identify 46 cases reported in the U.S. FAERS database. Priapism can be an adverse reaction to tamsulosin. Providers and patients should be aware about this complication to ensure early seeking of management to avoid devastating outcomes, particularly in young patients when tamsulosin is given as medical expulsive therapy for ureteral stone and stent-related symptoms.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580575PMC
http://dx.doi.org/10.1089/cren.2019.0157DOI Listing

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Tamsulosin in a widely used drug in urology practice in treating lower urinary tract symptoms of benign prostatic hyperplasia, distal ureteral stones, and ureteral stent-related symptoms. Ischemic priapism is a rare but serious adverse effect of tamsulosin. We report two cases of tamsulosin-induced priapism and reviewed available literature citing priapism as a complication of tamsulosin.

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Priapism secondary to tamsulosin: A case report.

Int J Surg Case Rep

June 2020

Department of Surgery, Division Urology, School of Medicine and Health Sciences, Atma Jaya Catholic University, Jl. Pluit Raya No. 2, Penjaringan, Utara, DKI Jakarta 14440, Indonesia. Electronic address:

Background: Tamsulosin is the most potent adrenergic alpha-1 antagonist used for treatment of benign prostatic hyperplasia (BPH). Priapism has been reported as a rare side effect through direct inhibition of the sympathetic input necessary for detumesence.

Presentation Of Case: We describe an otherwise healthy man with recurrent and then persistent unresolved priapism after the use of tamsulosin and concomitant use of ace inhibitor and beta blocker for hypertension.

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A systematic review of the literature about the causal relationship between priapism and adrenergic α-blockers used for the treatment of lower urinary tract symptoms (LUTS) and arterial hypertension was accomplished. While opportunely describing a case of tamsulosin-induced priapism, we reviewed the literature using MEDLINE, COCHRANE and LILACS libraries, selecting all the articles until the present time addressing the association between priapism and α-blockers. Our patient was a healthy 32-year-old man who reported LUTS.

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