[Physiopathologic aspects of priapism. Disease or symptom?]

The frequency of the iatrogenic priapism complicating the intracavernous injections of drugs for impotence has greatly improved the conceptions about priapism resulting in several novelties: a. definition: priapism may be defined as a pathological erection provoked by various anomalies of the erectile hemodynamics; a. pathogeny: at first, priapism is only the penile symptom of various diseases. Secondary and inconstantly, the priapism symptom become a priapism disease featured by an acute cavernous ischemia; c. physiopathology with two different priapisms: an unusual high flow priapism due to an acquired arteriocavernous fistula. A most usual stasis priapism due to a neuromuscular or hematological blockade of the cavernous detumescence of several origin; d. treatment: the stasis priapism alone is an genuine emergency. Puncture must be always the first treatment. If unsuccessful, the choice between pharmacological detumescence (new treatment for priapism) and surgery depends from both the physiopathological mechanisms and mainly the severity of the cavernous tissular suffering.