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Priapism.

John Pryor1, Emre Akkus, Gary Alter

  • 1Institute of Urology, London University, London, UK. jpryor@andrology.co.uk

The Journal of Sexual Medicine
|January 21, 2006
PubMed
Summary
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Priapism management guidelines are presented, covering low-flow, high-flow, and recurrent types. Urgent treatment for ischemic priapism is crucial to prevent erectile dysfunction, while high-flow priapism requires less immediate intervention.

Area of Science:

  • Urology
  • Sexual Medicine
  • Andrology

Background:

  • Priapism presents in three main forms: low-flow (ischemic), high-flow (nonischemic), and recurrent.
  • Understanding the distinct pathophysiology of each priapism type is essential for effective management.

Purpose of the Study:

  • To establish international consensus guidelines for the diagnosis and treatment of priapism.
  • To synthesize state-of-the-art knowledge from a multidisciplinary expert panel.

Main Methods:

  • An international consultation involving over 200 experts from 60 countries over a 2-year period.
  • Recommendations were developed through grading evidence-based literature, committee discussions, and public debate.

Main Results:

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  • Ischemic priapism requires urgent intervention (aspiration, alpha-blockers, shunting) to prevent erectile dysfunction.
  • High-flow priapism management is typically non-urgent, with selective embolization as a definitive treatment.
  • Recurrent priapism necessitates individualized treatment, with androgen deprivation showing utility despite potential side effects.

    • Conclusions:

    • Further prospective clinical trials are needed to refine management strategies for all priapism types.
    • Standardized guidelines are essential for optimizing patient outcomes in priapism care.