Priapism Flashcards
What is priapism?
An unwanted painful erection > 4 hrs, not associated with sexual desire
What are the types of priapism and what causes each of these?
High flow - non ischaemic - caused by unregulated cavernous arterial flow - blood flows in quicker than it can drain
Low flow - ischaemic - caused by a blockage to the venous drainage if the corpus cavernosum
Stuttering - recurrent priapism - cause unknown
What condition is associated with recurrent (stuttering) priapism?
Sickle Cell disease
When is priapism a emergency?
Ischaemic priapism - can lead to fibrosis + impotence if not treated
What are the complications of priapism?
Fibrosis
Impotence
Inability to have sexual intercourse
What can cause priapism?
- Idiopathic
- penile or perineal trauma
- spinal cord injury
- sickle cell disease
- other haematological disorders
- pelvic malignancies
- certain medications
How does priapism present?
Ongoing + unwanted erection that persists in absence of sexual desires
Ischaemic is often painful + fully rigid.
Non iscahemic is often not painful
How is priapism managed?
Corporeal aspiration
Intracavernosal injection - causes vasodilation (phenylephrine)
Surgery - shunt between the corpus cavernosum + the glans or spahenous vein.
What key investigation is done for initial assessment of priapism?
Corporeal blood gas - to distinguish is ischaemic or non ischaemic
Normally need a penile block
