Penis and scrotum
General
Priapism

Authors: Antonio Cubilla, M.D., Alcides Chaux, M.D. (see Authors page)

Revised: 28 March 2018, last major update May 2010

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Priapism[TIAB] penis[TI]

Cite this page: Cubilla, A., Chaux, A. Priapism. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumpriapism.html. Accessed November 14th, 2018.
Definition / general
Terminology
  • Either low flow / ischemic (disorder of venous outflow or stasis) or high flow / nonischemic (disorder of arterial flow, may be due to anatomic abnormality or perineal trauma with resulting fistula, Can Urol Assoc J 2009;3:60)
Etiology
  • Usually due to vascular diseases (sickle cell disease, leukemia, thalassemia, Fabry disease) or neurological disorders (spinal cord lesions / trauma) or medications (treatment for erectile dysfunction, antihypertensives, antipsychotics, antidepressants, blood thinners)
  • Metastatic carcinoma to the penis may present with "malignant" priapism in up to 40% of cases
Clinical features
  • Frequently associated with pain
  • May have fever and difficulty voiding
  • Associated with erectile dysfunction in 17 - 50%
  • Potential complications include ischemia, thrombosis and permanent impaired erectile dysfunction
Treatment
  • Low flow / ischemic priapism: prompt intervention is required; corpora cavernosal aspiration / irrigation with concomitant usage of a sympathomimetic agent; may also need systemic therapy if an underlying systemic disorder; surgical intervention may be necessary if medication fails (Rev Urol 2010;12:56)
  • High flow / nonischemic priapism: not a surgical emergency; resolves spontaneously in 60%, particularly if no underlying anatomic abnormality; selective arterial embolization if it persists