Priapism

Last reviewed: 4 Sep 2022
Last updated: 06 Sep 2022

Summary

Definition

History and exam

Key diagnostic factors

  • history of current systemic disease
  • history of vasoactive medication or drug use
  • prolonged erection of >4 hours' duration
  • painful rigid penis
  • penis not fully rigid and not painful
  • history of perineal or genitourinary trauma
More key diagnostic factors

Risk factors

  • haemoglobinopathy
  • vasoactive drugs
  • perineal or penile trauma
  • malignancies or local infection
  • spinal cord disease
More risk factors

Diagnostic investigations

1st investigations to order

  • corpus cavernosum blood sampling
  • FBC and differential
More 1st investigations to order

Investigations to consider

  • colour duplex ultrasonography
  • MRI
  • Hb-solubility testing
  • Hb electrophoresis
  • medication/toxicology urine screen
  • coagulation profile
More investigations to consider

Treatment algorithm

ACUTE

ischaemic or recurrent (stuttering) priapism

non-ischaemic priapism

ONGOING

recurrent (stuttering) priapism

Contributors

Authors

Martin S. Gross, MD

Assistant Professor of Surgery (Urology)

Section of Urology

Dartmouth-Hitchcock Medical Center

Lebanon

NH

Disclosures

MSG is a consultant for Coloplast. MSG is an author of a reference cited in this topic.

Acknowledgements

Dr Martin S. Gross would like to gratefully acknowledge Dr Helen R. Levey Bernie, Dr John Mulhall, Dr Trinity Bivalacqua, Dr Onder Canguven, and Dr Arthur L. Burnett, previous contributors to this topic.

Disclosures

HRLB and JM declare that they have no competing interests. TB is an author of a number of references cited in this topic. ALB has been reimbursed by Pfizer Inc. and Lilly LLC for attending symposia, speaking, organising education, and consulting, and has received research grants that support laboratory staff. OC declares that he has no competing interests.

Peer reviewers

Wayne Hellstrom, MD

Professor of Urology

Department of Urology

Tulane University Health Sciences Center

New Orleans

LA

Disclosures

WH declares that he has no competing interests.

Siam Oottamasathien, MD

Assistant Professor

Division of Pediatric Urology

University of Utah

Primary Children's Medical Center

Salt Lake City

UT

Disclosures

SO declares that she has no competing interests.

Gabriel Rodriguez, MD

Associate Professor

Section Head of Minimally Invasive Surgery

The University of Texas Medical Branch

Galveston

TX

Disclosures

GR declares that he has no competing interests.

Edmund Sabanegh, Jr, MD

Director

Center for Male Fertility

Glickman Urological and Kidney Institute

Cleveland

OH

Disclosures

ES declares that he has no competing interests.

Ates Kadioglu, MD

Professor of Urology

Division of Andrology

Department of Urology

Faculty of Medicine

Istanbul University

Istanbul

Turkey

Disclosures

AK declares that he has no competing interests.

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