- Serkan Deveci, MD
Serkan Deveci, MD
- Professor of Urology
- Medical School of Acibadem University
- Section Editors
- Michael P O'Leary, MD, MPH
Michael P O'Leary, MD, MPH
- Section Editor — Urology
- Professor of Surgery, Harvard Medical School
- Senior Urologic Surgeon, Brigham and Women's Hospital
- Robert S Hockberger, MD, FACEP
Robert S Hockberger, MD, FACEP
- Section Editor — Adult Signs and Symptoms
- Emeritus Professor of Medicine
- David Geffen School of Medicine at UCLA
The term "priapism" is derived from Priapus, the Greek god of fertility, gardening, and lust who is depicted with a massive phallus . Priapism is defined as a persistent erection of the penis or clitoris that is not associated with sexual stimulation or desire. The focus of this topic will be penile priapism. Studies differ on the length of time of erection used to define priapism, but most studies identify priapism as an erection lasting at least four hours. Priapism has been found to adversely impact patients’ quality of life, sexual function, and physical wellness .
Priapism is relatively rare, but can occur in all age groups and is particularly common in those with sickle cell disease. It is generally classified as ischemic or nonischemic. Ischemic priapism is a urologic emergency, whereas nonischemic priapism is usually self-limited.
Issues related to epidemiology, pathophysiology, diagnosis, and management of priapism will be reviewed here. Particular issues related to priapism in sickle cell disease are discussed separately. (See "Diagnosis and management of priapism in sickle cell disease".)
In a study of emergency room visits between 2006 and 2009 in the United States, there were 32,462 visits for priapism, which corresponded to an incidence of 0.73 per 100,000 men per year . Clitoral priapism occurs even less commonly .
Priapism can occur in any age group. However, there is a bimodal peak distribution of incidence, occurring between 5 and 10 years in children and 20 to 50 years in adults .
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- Ischemic priapism
- - Recurrent priapism
- Nonischemic (high flow) priapism
- CLINICAL MANIFESTATIONS AND DIAGNOSIS
- History and physical examination
- Cavernosal blood gas analysis
- Other blood studies
- Doppler ultrasonography
- Treatment of ischemic priapism
- - Surgical therapy
- Treatment of recurrent priapism
- Treatment of nonischemic (high flow) priapism
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS