The 10-year priapism experience: identifying clearer targets for intervention

Area of Science:

• Urology
• Emergency Medicine
• Clinical Practice

Background:

• Limited data exists on clinical priapism experience.
• Differences in practice patterns between urologists and emergency medicine (EM) physicians are underexplored.
• Understanding priapism patient populations can guide clinical efforts.

Purpose of the Study:

• To analyze the priapism patient population.
• To identify targets for clinical translational efforts in priapism management.
• To compare practice patterns of urologists and EM physicians.

Main Methods:

• Retrospective chart review of two priapism datasets (urology and EM) from June 2008 to July 2018.
• Analysis of patient encounters, duration of priapism, and acute interventions.
• Documentation of time to presentation, prior interventions, and evaluation.

Main Results:

• 396 priapism encounters in 95 unique patients over 10 years.
• Urology managed 199 encounters (83 patients); EM managed 197 encounters (15 patients).
• Median priapism duration was 6 hours for urology and 4 hours for EM; 72% and 89% required intervention, respectively.
• Nine patients accounted for 294 encounters due to recurrent priapism.

Conclusions:

• EM physicians and urologists manage similar numbers of priapism encounters, but EM patients present with shorter duration.
• Tailoring joint curriculum for initial priapism management and focusing complex cases for urology trainees is recommended.
• Recurrent ischemic priapism in a small patient subset highlights the need for outpatient prevention strategies.