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Priapism

Dongsheng Jiang, MS, MD and Joanna Jiang, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

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

  • Classification:

    • Ischemic (low-flow, veno-occlusive): 95% of cases. It 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

  • Based on the type:

    • Ischemic priapism: requires immediate treatment and urology consultation

      • Between 4 and 24 hours, initial conservative management should include pain control, encouraging eja...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Close follow-up with a urologist is mandatory. 

PROGNOSIS

  • Even with excellent treatment for a prolonged priapism, complete detumescence may requir...

REFERENCES

1
Anele UA, Morrison BF, Burnett AL. Molecular Pathophysiology of Priapism: Emerging Targets. Curr Drug Targets. 2015;16(5):474-483.
2
Huang  YC, Harraz  AM, Shindel  A...

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

SNOMED

  • 6273006 Priapism (disorder)

  • 441575009 Ischemic priapism

  • 441545004 Nonischemic ...

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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