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Clinical Management of Priapism: A Review
#MMPMID27169123
Shigehara K
; Namiki M
World J Mens Health
2016[Apr]; 34
(1
): 1-8
PMID27169123
show ga
Priapism is defined as a persistent and painful erection lasting longer than four
hours without sexual stimulation. Based on episode history and pathophysiology,
priapism is classified into three subtypes: ischemic (low-flow), non-ischemic
(high-flow), and stuttering priapism. Ischemic priapism is characterized by a
persistent, painful erection with remarkable rigidity of the corpora cavernosa
caused by a disorder of venous blood outflow from this tissue mass, and is
similar to penile compartment syndrome. Stuttering priapism is characterized by a
self-limited, recurrent, and intermittent erection, frequently occurring in
patients with sickle cell disease. Non-ischemic priapism is characterized by a
painless, persistent nonsexual erection that is not fully rigid and is caused by
excess arterial blood flow into the corpora cavernosa. Because ischemic and
non-ischemic priapism differ based on emergency status and treatment options,
appropriate discrimination of each type of priapism is required to initiate
adequate clinical management. The goal of management of priapism is to achieve
detumescence of the persistent penile erection and to preserve erectile function
after resolution of the priapism. To achieve successful management, urologists
should address this emergency clinical condition. In the present article, we
review the diagnosis and clinical management of the three types of priapism.
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