Penis and scrotum
General
Priapism


Topic Completed: 1 May 2010

Revised: 12 February 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Priapism[TIAB] penis[TI]

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
Page views in 2018: 109
Page views in 2019 to date: 130
Cite this page: Chaux A, Cubilla AL. Priapism. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumpriapism.html. Accessed September 17th, 2019.
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
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