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Review of Ischemic and Non-ischemic Priapism

  • Men’s Health (R Carrion, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Priapism is a rare condition that has different presentations, etiologies, pathophysiology, and treatment algorithms. It can be associated with significant patient distress and sexual dysfunction. We aim to examine the most up-to-date literature and guidelines in the management of this condition.

Recent Findings

Priapism is a challenging condition to manage for urologists, since the etiology is often multi-factorial and the suggested treatment algorithms are based on small studies and expert anecdotal experience, perhaps due to the rarity of the disorder.

Summary

Ischemic priapism of less than 24 h can be managed non-surgically in most cases with excellent results. Ischemic priapism of more than 36 h is frequently associated with permanent erectile dysfunction. Management of prolonged priapism with penile shunting still may result in poor erectile function, so penile prosthesis can be discussed in these scenarios.

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Data Availability

Not applicable.

Code Availability

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Abbreviations

PDE:

Phosphodiesterase

OR:

Operating room

IPP:

Inflatable penile prosthesis

MPP:

Malleable penile prosthesis

AUA:

American Urological Association

EAU:

European Association of Urology

US:

Ultrasound

ED:

Erectile dysfunction

ER:

Emergency room

SCD:

Sickle cell disease

ROS:

Reactive oxygen species

NO:

Nitric oxide

eNOS:

Endothelial nitric oxide synthase

MRI:

Magnetic resonance imaging

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  1. Boston Medical Center, Boston University School of Medicine, 725 Albany street, suite 3B, Boston, MA, 02118, USA

    Mark G. Biebel & Ricardo Munarriz

  2. Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA

    Martin S. Gross

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Biebel, M.G., Gross, M.S. & Munarriz, R. Review of Ischemic and Non-ischemic Priapism. Curr Urol Rep 23, 143–153 (2022). https://doi.org/10.1007/s11934-022-01096-8

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