Molecular science of priapism

Priapism refers to the nonwillful persistence of penile erection in the absence of sexual excitation, and thus it constitutes a true sexual dysfunction. At present, the precise pathophysiologic basis for the disorder remains largely misunderstood, particularly with respect to its recurrent or "stuttering" clinical presentations. New concepts in this field of study suggest that priapism often results from altered vascular homeostatic actions in the penis and is associated with deficient erection control mechanisms on a molecular level. A leading proposal is that aberrant signaling of the nitric oxide signal transduction pathway in the penis is a principal mechanism. Additionally, dysfunctional regulatory control of signal transduction systems that interact with this pathway may contribute to the display of priapism. These advances have paved the way for understanding this disorder as having a molecular pathogenesis. As the molecular science underlying priapism further emerges, increasingly effective therapeutics for priapism are certain to follow.