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Priapism Anaesthesia — FRCA Final MCQ

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HardGeneral AnaesthesiaPriapism AnaesthesiaFRCA Final

A 35-year-old man (ASA I) presents to A&E with priapism following intracavernosal injection of alprostadil. He is in severe pain. The urologist performs aspiration and irrigation with phenylephrine. If general anaesthesia had been required for surgical shunt creation, which anaesthetic drugs should be avoided?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — No specific drugs need to be avoided

There are no specific anaesthetic drugs that need to be avoided in priapism management requiring general anaesthesia. The key considerations are adequate analgesia, avoidance of drugs that could worsen detumescence failure, and awareness of any drugs the patient may have taken (PDE5 inhibitors, trazodone). While some older texts suggested avoiding halothane (cardiac sensitisation to catecholamines when phenylephrine is used), this drug is no longer used in clinical practice. Any modern standard anaesthetic technique is acceptable.

Reference: RCOA – 2023 – Urological anaesthesia module; BAUS – 2018 – Priapism guidelines