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Priapism.

A Melman1, S Serels

  • 1Department of Urology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA. Amelman@montefiore.org

International Journal of Impotence Research
|October 18, 2000
PubMed
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Priapism, a prolonged erection, has two types: low-flow (ischemic) and high-flow (non-ischemic). Low-flow priapism is common, painful, and requires immediate treatment to prevent penile fibrosis.

Area of Science:

  • Urology
  • Andrology
  • Emergency Medicine

Background:

  • Priapism is a prolonged erection lasting over 4-6 hours, often painful after 6-8 hours.
  • It signifies a failure in the penile detumescence mechanism.
  • Causes include neurotransmitter imbalance, venous obstruction, or smooth muscle relaxation.

Purpose of the Study:

  • To differentiate between the two main types of priapism: high-flow (non-ischemic) and low-flow (ischemic).
  • To outline the clinical characteristics and diagnostic features of each type.
  • To emphasize the urgency of treatment for low-flow priapism.

Main Methods:

  • Clinical observation and differentiation of priapism subtypes.
  • Analysis of penile blood aspirate characteristics (color, pO2).

Related Experiment Videos

  • Review of etiological factors including trauma, idiopathic causes, and sickle cell disease.

    • Main Results:

    • Low-flow priapism: common, associated with decreased venous outflow, vascular stasis, hypoxia, acidosis, dark blood aspirate, and significant pain.
    • High-flow priapism: less common, often trauma-related, characterized by increased arterial inflow, normal venous outflow, bright red blood aspirate with high pO2, and typically non-painful.
    • Low-flow priapism necessitates immediate intervention to prevent penile fibrosis.

    Conclusions:

    • Priapism presents as either low-flow (ischemic) or high-flow (non-ischemic).
    • Distinguishing between these types is crucial for appropriate management.
    • Prompt treatment for low-flow priapism is essential to avoid long-term complications like erectile dysfunction.