Management of Priapism in the Emergency Department

Abstract

Patients presenting to the emergency department with priapism require immediate evaluation and treatment. Priapism is a urological emergency that carries the risk of erectile dysfunction if not managed in a timely manner. Therefore, it is important for providers to be able to identify and manage these patients emergently. Priapism has various causes, and knowing the difference between highflow and low-flow priapism will help determine the appropriate patient management. Although the prevalence of priapism is thought to be low, there have been increasing reports over the years linked to new drugs used for the treatment of erectile dysfunction (Roghmann et al., 2013). For this reason, it is imperative that providers understand the etiology behind the different causes of priapism. Using a case of drug-induced priapism as an exemplar, this article discusses the epidemiology, etiology, and management of priapism conditions.

Case Report

“…Common risk factors for ischemic priapism are having a history of sickle cell anemia, illicit drug use (cocaine and marijuana), use of phosphodiesterase 5 inhibitors, antihypertensives, neuroleptics, and intracavernosal injections (Helman, 2021). Nonischemic or high-flow pri-apism is observed less frequently and occurs more often after trauma that causes lacerated blood vessels leading to pooling of blood within the penis (Adams & Evans, 2022). History and physical examination, Doppler ultrasound, and corporal blood gases are used to make the differential diagnosis.…”