A recent Journal of Sexual Medicine study reports that using higher doses of phenylephrine to treat ischemic priapism could be an effective approach.  But experts caution that more research is needed before the strategy can become routine.

The study was prepared by physicians who use higher doses and concentrations of phenylephrine than those recommended in American Urological Association guidelines. 

The researchers looked at data from 58 men who had visited the emergency department for ischemic priapism. In total, the men made 136 visits over 5 years. 

All of the men received phenylephrine injections ranging from 200-1000 μg with each injection, with total amounts of 0.3-12 mg instilled.

The treatment was successful for 86% of the men and in 94% of the emergency room visits. No complications were reported. 

However, experts warn that, while rare, cerebrovascular hemorrhage and death are possible with this approach. Clinicians should always inject the phenylephrine slowly and carefully monitor the patient's blood pressure.

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Transgender patients who transition from the female gender to the male gender often desire a more masculine chest.

Subcutaneous mastectomy is one possible route, which we discuss in the latest addition to our website's Q & A section: 

What options are available for transmen who are unhappy with the appearance of their breasts?

What sexual health concerns do your patients have? Our Q & A section can answer many of them, but we always welcome topic suggestions. Please feel free to send your ideas to us at QandA@issm.info.