Arrêt de service programmé du vendredi 10 juin 16h jusqu’au lundi 13 juin 9h. Pour en savoir plus
Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Successful medical treatment of glans ischemia after voluntary buprenorphine injection

Abstract :

INTRODUCTION: The diverted use of synthetic opioid buprenorphine by drug addicts can be responsible for serious ischemic and infectious complications, particularly in the case of intravenous injection. AIM: We present a case of serious glans ischemia after buprenorphine injection directly into the deep dorsal vein of the penis. Analysis using new medical imaging techniques and treatments is detailed below. METHODS: A 26-year-old male drug addict presented with glans pain 4 days after self-injection of buprenorphine into the deep dorsal vein of the penis. The patient was apyretic and presented a urethral discharge. His glans was blue without discoloration on digital pressure. Additionally, his biologic and serologic tests were normal while bacteriology showed the presence of Enterobacter cloacae urethritis. RESULTS: After 48 hours of intravenous antibiotic treatment without improvement, a specific medical treatment using enoxaparin and ilomedin was initiated, with the assumption that there was an ischemic complication. Laser speckle contrast imaging allowed confirmation of the presence of distal penis ischemia and provided an accurate mapping of the ischemic zone. A 28-day treatment combining antibiotics, subcutaneous heparin at curative dose, antiplatelet drug, ilomedin, and hyperbaric oxygen therapy resulted in clinical improvement of the lesions with no functional complications. CONCLUSIONS: To date, no consensus exists on the proper diagnostic and treatment approach to severe glans ischemia due to buprenorphine injection into the deep dorsal vein of the penis. The results of laser speckle contrast imaging were of real interest during the process of diagnosis. In addition, the combination of ilomedin with hyperbaric oxygen therapy and anticoagulant and antiplatelet drugs appeared to be an effective therapy.

Type de document :
Article dans une revue
Liste complète des métadonnées

https://hal.univ-angers.fr/hal-03404135
Contributeur : Okina Univ Angers Connectez-vous pour contacter le contributeur
Soumis le : mardi 26 octobre 2021 - 14:32:44
Dernière modification le : mercredi 27 octobre 2021 - 04:04:39

Identifiants

Collections

Citation

Abdel Rahmene Azzouzi, Pierre Bigot, F. Brecheteau, P. Grison, Pierre Abraham, et al.. Successful medical treatment of glans ischemia after voluntary buprenorphine injection. The journal of sexual medicine, 2013, 10 (11), pp.2866 - 70. ⟨10.1111/jsm.12282⟩. ⟨hal-03404135⟩

Partager

Métriques

Consultations de la notice

6