Management of priapism: An update for clinicians

Helen R. Levey, Robert L. Segal, Trinity Bivalacqua

Research output: Contribution to journalArticle

Abstract

Priapism is a prolonged erection that persists beyond or is unrelated to sexual stimulation. It is associated with significant morbidity: psychological, socioeconomic, and physical, including pain and potentially irreversible compromise of erectile function. There are three major types of priapism: ischemic, nonischemic, and stuttering. Establishing the type of priapism is paramount to safely and effectively treating these episodes. Ischemic priapism represents a urological emergency. Its treatment may involve aspiration/irrigation with sympathomimetic injections, surgical shunts, and as a last resort, penile prosthesis implantation. Nonischemic priapism results from continuous flow of arterial blood into the penis, most commonly related to penile trauma. This is not an emergency and may be managed conservatively initially, as most of these episodes are self-limiting. Stuttering priapism involves recurrent self-limiting episodes of ischemic priapism. The primary goal of therapy is prevention, but acute episodes should be managed in accordance with guidelines for ischemic priapism. In this paper we review the diagnosis and treatment of the three priapism variants, as well as discuss future targets of therapy and novel targets on the horizon.

Original languageEnglish (US)
Pages (from-to)230-244
Number of pages15
JournalTherapeutic Advances in Urology
Volume6
Issue number6
DOIs
StatePublished - Dec 26 2014

Fingerprint

Priapism
Stuttering
Emergencies
Penile Implantation
Sympathomimetics
Penis
Therapeutics
Guidelines
Psychology
Morbidity
Pain
Injections

Keywords

  • guidelines
  • ischemic
  • non-ischemic
  • priapism
  • recurrent
  • stuttering

ASJC Scopus subject areas

  • Urology

Cite this

Management of priapism : An update for clinicians. / Levey, Helen R.; Segal, Robert L.; Bivalacqua, Trinity.

In: Therapeutic Advances in Urology, Vol. 6, No. 6, 26.12.2014, p. 230-244.

Research output: Contribution to journalArticle

Levey, Helen R. ; Segal, Robert L. ; Bivalacqua, Trinity. / Management of priapism : An update for clinicians. In: Therapeutic Advances in Urology. 2014 ; Vol. 6, No. 6. pp. 230-244.
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