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Priapism

Reviewed 06/2020
 


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.
2
Donaldson JF, Rees RW, Steinbrecher HA. Priapism in child...

ADDITIONAL READING

  • Butaney M, Thirumavalavan N, Rodriguez D, et al. Current practice in the management of ischemic priapism: an anonymous survey of ISSM members. Int J Impot Res.  2019;31(6):404–...

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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