A 29-year-old man comes to the emergency department because of a 6-hour history of persistent, painful erection. He has a history of major depressive disorder and a new medication has been added recently to control his relapsing symptoms. The patient has had no trauma to the perineal or genital area. Temperature is 37 C (98.6 F), blood pressure is 124/82 mm Hg, pulse is 84/min, and respirations are 16/min. Examination shows an engorged corpora cavernosa and a rigid, tender penis. The testicles are normal, and the remainder of the examination shows no abnormalities. Penile injection with a medication having which of the following mechanisms would most likely relieve this patient's symptoms?

Question

A 29-year-old man comes to the emergency department because of a 6-hour history of persistent, painful erection. He has a history of major depressive disorder and a new medication has been added recently to control his relapsing symptoms. The patient has had no trauma to the perineal or genital area. Temperature is 37 C (98.6 F), blood pressure is 124/82 mm Hg, pulse is 84/min, and respirations are 16/min.  Examination shows an engorged corpora cavernosa and a rigid, tender penis.  The testicles are normal, and the remainder of the examination shows no abnormalities.  Penile injection with a medication having which of the following mechanisms would most likely relieve this patient's symptoms?

Quizplus · Accepted Answer

Eductional Objective: Trazodone is an atypical antidepressant with alpha-1 receptor antagonistic effects that can lead to increased blood flow to the corpus cavernosum and priapism. First-line treatment includes aspiration of blood from the corpus cavernosum and injection of an alpha-adrenergic agonist (eg, phenylephrine) to reduce blood flow to this compartment. Without treatment, this patient is at risk of irreversible ischemia and chronic erectile dysfunction.

A 29-Year-Old Man Comes to the Emergency Department Because of a 6-Hour