Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Oct;6(4):366-8.
doi: 10.4103/0974-7796.141012.

Priapism associated with pregabalin

Ali A Alsulihem  1 , Danny M Rabah  2
Affiliations
Case Reports

Priapism associated with pregabalin

Ali A Alsulihem et al. Urol Ann. 2014 Oct.

Abstract

Priapism is a well-known cause of erectile dysfunction. There are a wide variety of causes, including hemoglobinopathy, neurological diseases, and drugs. We present a case report of an Asian man who presented with priapism that was continuous for 3 days after taking three doses of pregabalin for chronic back pain. Cavernous aspiration, phenylephrine injection, and a winter shunt all failed to achieve detumescence. The patient then presented to our institution on the 5(th) day of his initial presentation, and an El-Ghorab shunt was performed, after which detumescence and pain relief were achieved. We suggest that pregabalin might induce tumescence through acting on the α2δ1 subunit of voltage-gated calcium channels in the penile smooth muscle or by presynaptic inhibition of noradrenaline release. Further studies are warranted regarding the action of pregabalin and its effect on penile physiology.

Keywords: Drug-induced priapism; pregabalin; priapism.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
Schematic representation of free cytosolic calcium: (1) Adrenergic nerve fiber endings and (2) endothelial cells release norepinephrine, endothelins, and PGF2α, which lead to initiate the cascade of reactions that eventually result in elevation of free cytosolic Ca++ concentrations. (3) Voltage-gated calcium channels are another source of free cytosolic calcium that lead to an increase in the level of free cytosolic Ca++ due to an influx of extracellular calcium. Voltage-gated calcium channels in the nerve fibers are thought to aid in depolarization leading to the release of neurotransmitters
Figure 2
Figure 2
Pregabalin targets the voltage-gated calcium channels, leading to inhibition of Ca++ influx into excitable cells. (1) Pregabalin acts on voltage-dependent Ca++ channels of the corporal smooth muscle, leading to decrease in Ca++ influx into the smooth muscle and a resultant decrease in free cytosolic Ca++ level and, ultimately, smooth muscle relaxation. (2) Pregabalin acts on the voltage-dependent Ca++ channels of the adrenergic nerves, which leads to decrease in the excitability of nerves and decrease in norepinephrine release, resulting in a decrease in the release of intracellular Ca++ stores
See this image and copyright information in PMC

References

    1. Burnett AL. Priapism. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 9th ed. Philadelphia: Saunders Elsevier; 2007. pp. 839–49.
    1. Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, et al. American Urological Association guideline on the management of priapism. J Urol. 2003;170:1318–24. - PubMed
    1. Zhang J, Ho KY, Wang Y. Efficacy of pregabalin in acute postoperative pain: A meta-analysis. Br J Anaesth. 2011;106:454–62. - PubMed
    1. Bannister K, Sikandar S, Bauer CS, Dolphin AC, Porreca F, Dickenson AH. Pregabalin suppresses spinal neuronal hyperexcitability and visceral hypersensitivity in the absence of peripheral pathophysiology. Anesthesiology. 2011;115:144–52. - PMC - PubMed
    1. Bandelow B, Wedekind D, Leon T. Pregabalin for the treatment of generalized anxiety disorder: A novel pharmacologic intervention. Expert Rev Neurother. 2007;7:769–81. - PubMed

Publication types