Current Sexual Health Reports

, Volume 6, Issue 1, pp 38–44 | Cite as

Priapism: an Update on Principles and Practices

Part of the following topical collections:
  1. Topical Collection on Male and Female Surgical Interventions


Priapism is an erectile disorder in which erection persists uncontrollably without sexual purpose. It exists in two forms: ischemic (or low-flow) priapism, which represents the majority of cases, and nonischemic (high-flow) priapism. This condition requires prompt evaluation and management to prevent long-term sequelae of ischemic priapism, most notably erectile dysfunction. It is important that initial diagnostic steps identify the proper form of priapism because ischemic priapism is an emergency that must be treated as quickly as possible. Initial evaluation must include a history and physical exam and a corporeal blood gas analysis. Initial treatment is therapeutic aspiration of blood and subsequent intracavernous injection of sympathomimetic drugs. Only after failure of these conservative measures is the use of surgical shunts appropriate. Nonischemic priapism is not an emergency. Initial management is observation, followed by arterial embolization for patients who request intervention.


Priapism Erectile dysfunction Ischemic priapism Nonischemic priapism Stuttering priapism Surgical shunt Surgical cannulation Risk factors Diagnosis Surgical therapy Medical therapy 


Compliance with Ethics Guidelines

Conflict of Interest

Nathaniel Readal and Arthur L. Burnett declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  1. 1.Brady Urological InstituteJohns Hopkins Medical InstitutionBaltimoreUSA

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