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priapism [2020/02/22 10:53] (current)
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 +====== priapism ======
 +
 +see also:
 +  *[[urology]]
 +
 +
 +=====Introduction=====
 +  *priapism is the unwanted, very prolonged (more than 4hrs without sexual stimulation) erection of the penis which may constitute a rare urologic emergency as risk of permanant scarring of the penis increases after 4hrs of ischaemic priapism and occurs in all patients after 48hrs of ischaemic priapism, this may result in disfigurement,​ erectile dysfunction or in severe cases, penile gangrene
 +  *rarely, clitoral priapism may occur in women
 +  *named after the Greek fertility god Priapus who is often represented with a disproportionately large, permanent erection
 +  *there are 3 main types:
 +    * **ischaemic priapism** (low blood flow)
 +      * accounts for over 90% of cases of priapism
 +      * painful, most of penis is hard except for the glans
 +      * most commonly caused by [[sickle_cell]]
 +      * Mx is usually with anaesthetic penile nerve block and aspiration of blood from the corpus cavernosum
 +    ***non-ischaemic priapism** (high blood flow)
 +      * whole of penis is only moderately hard 
 +      * this is usually due to [[trauma_mx|acute spinal cord injury]] or blunt trauma to the penis causing laceration of the cavernous artery and resultant arterial-lacunar fistula
 +      * Mx is usually with cold packs and compression
 +    ***recurrent ischaemic intermittent priapism**
 +      *  ​
 +
 +
 +=====Aetiology of priapism=====
 +  *[[sickle_cell]]
 +    * affects over 40% of men with sickle cell at some stage
 +    * initial Rx is usually with intravenous fluids, pain medication, and oxygen therapy, but if ressolution does not occur then aspiration is indicated
 +  *medications
 +    * drugs used to Rx erectile dysfunction:​
 +      * [[sildenafil]] (Viagra)
 +    * [[antipsychotics]] such as [[chlorpromazine]]
 +    * [[SSRIs]] such as [[fluoxetine]]
 +    * prostaglandin E1
 +    * [[NSAIDs]]
 +    * [[warfarin]]
 +    * [[alphablockers]]
 +    * [[cocaine]]
 +    * [[marijuana]]
 +  *[[myelofibrosis]],​ [[myeloproliferative_disorders]],​ [[myeloma]],​ [[thalassaemia]],​ [[leukaemia]]
 +  *[[malaria]]
 +  *[[dermatomyositis]]
 +  *[[redback_spider]] or scorpion stings
 +  *[[gout]]
 +  *[[trauma_mx|acute spinal cord injury]]
 +  *penile or perineal trauma
  
priapism.txt ยท Last modified: 2020/02/22 10:53 (external edit)