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General Medicine

Priapism

Sundonia J. W. Wonnum, PhD, LCSW and Christine M. Broszko, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Penile (or less common clitoral) erection lasting for >4 hours and unrelated to sexual stimulation or arousal

  • Classified into three types: ischemic, nonischemic, and stuttering:

    • Isc...

DIAGNOSIS

HISTORY

  • Prior priapism episodes or prolonged erections after waking and degree of pain

  • Duration of erection

  • Perineal or penile trauma (blunt force or needle injury)

  • Urination difficult during er...

TREATMENT

  • Treatments for priapism are determined based on the three main types: ischemic, nonischemic, and stuttering (7).

    • Ischemic priapism requires immediate treatment to preserve future erectile fun...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Further evaluation of underlying etiologies and reduction of vasoactive drug therapy as indicated 

Patient Monitoring

Close follow-up with a urologist is recommende...

REFERENCES

1
Huang YC, Harraz AM, Shindel AW, et al. Evaluation and management of priapism: 2009 update. Nat Rev Urol.  2009;6(5):262–271. [View Abstract on OvidMedline]
2
Donaldson JF, Rees RW, Ste...

ADDITIONAL READING

Pryor J, Akkus E, Alter G, et al. Priapism. J Sex Med.  2004;1(1):116–120. [View Abstract on OvidMedline] 

SEE ALSO

Anemia, Sickle Cell; Erectile Dysfunction 

CODES

ICD10

  • N48.30 Priapism, unspecified

  • N48.39 Other priapism

  • N48.31 Priapism due to trauma

  • N48.33 Priapism, drug-induced

ICD9

607.3 Priapism 

SNOMED

  • 6273006 Priapism (disorder)

  • 441575009 Ischemic priapism

  • 441...

CLINICAL PEARLS

  • Priapism is a prolonged penile erection that lasts >4 hours and is unrelated to sexual stimulation. If priapism lasts >24 hours, it likely results in permanent sexual impairment.

  • ...

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Sickle cell anemia. A peripheral blood smear shows numerous sickled cells, as well as normoblasts and occasional target cells. The erythrocyte to the left of center contains a Howell-Jolly body, indicative of functional hyposplenism.
Sickle cell anemia. A peripheral blood smear shows numerous sickled cells, as well as normoblasts and occasional target cells. The erythroc...
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