[Priapism: Current diagnostics and therapy]

Area of Science:

• Urology
• Andrology
• Emergency Medicine

Context:

• Priapism is defined as persistent penile erection unrelated to sexual stimulation.
• Accurate diagnosis involves patient history, physical examination, duplex ultrasonography, and blood gas analysis.
• Distinguishing between low-flow (ischemic) and high-flow (non-ischemic) priapism is critical for management.

Purpose:

• To outline the diagnostic approach to priapism.
• To differentiate between ischemic and non-ischemic priapism based on pathophysiology.
• To detail appropriate therapeutic strategies for various priapism presentations.

Summary:

• Low-flow priapism is a medical emergency requiring immediate intervention like aspiration and sympathomimetic injection to prevent erectile dysfunction.
• High-flow priapism typically requires observation, with selective artery embolization considered for associated fistulas.
• Recurrent priapism management involves self-injection protocols and potential long-term pharmacotherapy, though further validation is needed.

Impact:

• Timely and accurate diagnosis of priapism can prevent long-term complications such as corporal fibrosis and irreversible erectile dysfunction.
• Appropriate treatment selection based on priapism type optimizes functional outcomes and patient quality of life.
• This approach provides a framework for managing diverse priapism scenarios, from acute emergencies to recurrent conditions.