以阴茎异常勃起为首发症状的白血病5例并文献复习

Report of 5 Cases of Leukemia with Priapism as the First Symptom and the Literature Review

目的 :探讨阴茎异常勃起为首发症状的白血病的诊断和治疗原则。方法 :回顾性分析了 5例首诊入住泌尿外科 ,以阴茎异常勃起为首发症状的白血病患者的临床资料。结果 :5例阴茎异常勃起均为慢性粒细胞白血病所致 ,均伴有不同程度的脾肿大和血象异常。1例阴茎尿道海绵体分流 ,1例阴茎海绵体切开 ,3例行海绵体抽吸冲洗术。1例海绵体部分纤维化 ,勃起功能障碍 ,余 4例均取得了较好疗效。结论 :以阴茎异常勃起为首发症状的白血病误诊率高。对白血病性阴茎异常勃起应采用综合方法治疗 ,化疗是主要的治疗措施 ,阴茎持续勃起时间长者应尽早行外科处理。

Objective:To investigate the diagnosis and treatment of leukemia with priapism as the first symptom.Methods:Clinical data of 5 patients with leukemic priapism were collected and discussed in combination with related literature.Results:5 patients with priapism had an etiologic diagnosis of chronic granulocytic leukemia(CGL) accompanied by splenic tumescence as well as abnormity of blood routine test. 3 cases received aspiration and irrigation of the corpora cavernosa, 1 case was treated by cavernosum-spongiosum shunt,and 1 case was treated by cavernosa incision.4 patients remained function of erection after various forms of treatment, while 1 patient had erectile dysfunction.Conclusions:Leukemic was easily misdiagnosed when priapism was the first symptom.Compr ehensive treatment should be performed in patients with leukemic priapism. If general treatments such as analgesics, chemotherapy and radiotherapy showed little effects,Surgical treatment should be considered in time.