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General Medicine

Priapism

Sundonia J. W. Wonnum, PhD and Christine Broszko, MD Reviewed 06/2018
 


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:

    • I...

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.

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

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, St...

ADDITIONAL READING

  • Burnett AL. Pathophysiology of priapism: dysregulatory erection physiology thesis. J Urol.  2003;170(1):26–34. [View Abstract on OvidMedline]

  • Kousournas G, Muneer A, Ralph D, e...

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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