Priapism: Current Updates in Clinical Management

Abstract

Priapism is a persistent penile erection that continues for hours beyond, or is unrelated to, sexual stimulation. Priapism requires a prompt evaluation and usually requires an emergency management. There are two types of priapism: 1) ischemic (veno-occlusive or low-flow), which is found in 95% of cases, and 2) nonischemic (arterial or high-flow). Stuttering (intermittent or recurrent) priapism is a recurrent form of ischemic priapism. To initiate appropriate management, the physician must decide whether the priapism is ischemic or nonischemic. In the management of an ischemic priapism, resolution should be achieved as promptly as possible. Initial treatment is therapeutic aspiration with or without irrigation of the corpora. If this fails, intracavernous injection of sympathomimetic agents is the next step. Surgical shunts should be performed in cases involving failure of nonsurgical treatment. The first management of a nonischemic priapism should be observation. Selective arterial embolization is recommended for the management of nonischemic priapism in cases that request treatment. The goal of management for stuttering priapism is prevention of future episodes. This article provides a review of recent clinical developments in the medical and surgical management of priapism and an investigation of scientific research activity in this rapidly developing field of study.

Ischemic priapism: Can eosinophil count and platelet functions be positive predictive factors in etiopathogenesis

“…It is often observed in males aged 20-50. 2,3 Although the possible causes of priapism differ according to priapism types, it is observed that it is mostly related to idiopathic and iatrogenic causes. Alcohol, medicine, drug use (21%), perineal trauma (12%), and or sickle cell nephropathy (5%) are other possible etiological causes.…”

“…Shuttering priapism is demonstrated by recurrent and intermittent erections. [1][2][3][4] Due to the frequent use of phospodiesterase enzyme 5 (PDE5) inhibitors in erectile dysfunction (ED) treatment and the use of penile Doppler ultrasonography (PDU) for ED diagnosis, priapism cases have increased recently.…”

“…Alcohol, medicine, drug use (21%), perineal trauma (12%), and or sickle cell nephropathy (5%) are other possible etiological causes. 3 Three types of priapism exist: ischemic (venoocclusive, low-flow), non-ischemic (arterial, high-flow), and stuttering (recurrent). The causes and treatment methods of each priapism type are different.…”

Priapism: what to do?

“…Additionally, abdominal and rectal examination should be done to exclude the presence of malignity which may cause ischemic priapism. 3,6 …”

“…5,6 Priapism is an urgent urological disease which should be managed well since it may cause severe penile function disorder. Our aim in this article is presenting appropriate management of priapism in the light of current literature.…”