Priapism

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Priapism is a prolonged erection of the penis. The unwanted, persistent erection is not caused by sexual stimulation or arousal, and priapism is usually painful. Pathologic condition of persistent (>4 hours) penis erection in the absence of sexual excitation. Classified as ischemic, nonischemic, or recurrent-stuttering. Diagnosis is based on history, clinical findings, and assessment of cavernous blood gases and-or color duplex ultrasound. Acute episodes of recurrent or stuttering priapism are managed the same as ischemic priapism, followed by treatment of any underlying condition (e.g., sickle cell disease). In some patients, hormonal therapy may be of benefit. Treatment of priapism should progress in a stepwise fashion. Ischemic priapism warrants emergency management. First-line therapy includes therapeutic aspiration of blood with intracavernous injection of diluted alpha-adrenergic sympathomimetic agents. Surgical shunt procedures are performed in refractory cases. Complication includes erectile dysfunction and penis fibrosis. Nonischemic priapism is managed by observation. If a patient desires active treatment, selective cavernosal artery embolization may be considered.

Symptoms:

Laboratory Test Procedures:

unwanted erection lasting more than four hours
rigid penile shaft, but usually soft tip of penis (glans)

pO2 (partial pressures of oxygen)
pH - arterial blood
pCO2 (partial pressures of carbon dioxide)
WBC
Hemoglobin
Hematocrit
Reticulocyte Count
Platelet Count
Sickle
Protime/INR
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