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priapism

priapism

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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 disease (SCD)
      • 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 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

priapism.txt · Last modified: 2020/02/22 10:53 (external edit)