Exploring the Clinical Landscape of Priapism Related to Intracavernosal Injection Therapy: Patient Characteristics,...

Area of Science:

• Urology
• Andrology
• Sexual Medicine

Background:

• Priapism is a prolonged erection, often associated with intracavernosal injection (ICI) therapy for erectile dysfunction (ED).
• Understanding the patterns and outcomes of ICI-induced priapism is crucial for patient management.

Purpose of the Study:

• To evaluate clinical characteristics, risk factors, and outcomes of priapism following ICI therapy.
• To compare priapism patterns based on in-office, prescribed, and recreational ICI use.

Main Methods:

• Retrospective review of 186 priapism cases (ICD-10: N48.3) from November 2015 to September 2024.
• Classification of priapism (ischemic, recurrent, non-ischemic) and stratification by ICI setting (in-office, prescribed, recreational).
• Analysis of demographics, presentation, management, and erectile function outcomes.

Main Results:

• 102 cases (54.8%) were ICI-related, predominantly acute ischemic (75.4%).
• Priapism duration varied significantly: 3 hours (in-office), 7 hours (prescribed), and 30 hours (recreational).
• Recreational users showed higher rates of HIV, illicit drug use, and de novo erectile dysfunction (65%).

Conclusions:

• ICI-induced priapism is a significant clinical issue with duration dependent on usage patterns.
• Priapism often leads to discontinuation of prescribed ICI therapy (57%).
• Recreational ICI use is linked to adverse outcomes, necessitating targeted risk mitigation and clinical outreach.