Recent advances in understanding and treating priapism.

Area of Science:

• Urology
• Andrology
• Emergency Medicine

Background:

• Priapism is a rare urological emergency defined as a prolonged erection lasting over 4 hours.
• Untreated priapism can lead to irreversible erectile dysfunction and penile fibrosis.
• Prompt medical intervention is crucial for managing priapism and preserving erectile function.

Purpose of the Study:

• To review and evaluate the latest advancements in the management of priapism.
• To highlight current best practices for treating both ischemic and non-ischemic priapism.
• To discuss the evolution of surgical techniques and conservative management strategies.

Main Methods:

• Review of recent clinical and basic science research on priapism management.
• Analysis of current surgical techniques, including distal shunt procedures and novel decompression methods.
• Evaluation of outcomes for conservative management and early intervention strategies.

Main Results:

• Distal shunt procedures are now the most common surgical technique for priapism.
• Conservative management is effective for most ischemic priapism cases, preserving erectile function.
• Early penile prosthesis or super-selective embolization may be necessary for persistent or long-standing cases to prevent complications.

Conclusions:

• Advances in research have improved the understanding and management of priapism.
• Current treatment strategies emphasize timely intervention, with distal shunts being preferred surgically.
• Optimal management depends on the type and duration of priapism, aiming to preserve erectile function and prevent long-term sequelae.