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Priapism

Dongsheng Jiang, MS, MD and Joseph P Wiedemer, MD Reviewed 04/2024
 


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): accounts for 95% o...

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

      • Initial conservative management with encouraging ejaculation, vigorous physical exercise, cold bath,...

ONGOING CARE

PROGNOSIS

  • Even with excellent treatment for a prolonged priapism, complete detumescence may require several weeks secondary to edema.

  • Impotence due to irreversible corporal fibrosis is like...

REFERENCES

1
Anele UA, Morrison BF, Burnett AL. Molecular Pathophysiology of Priapism: Emerging Targets. Curr Drug Targets. 2015;16(5):474-483.
2
Ericson C, Baird B, Broderick GA. Management of Priapism...

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

  • If priapism lasts >24 hours, it likely results in permanent sexual impairment.

  • Priapism can occur in children, particularly in SCD. Treatment should address both the underlying disea...

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