Priapism (2)

Question 1

What is it?

Why’s it a an emergency?

What are its 2 main categories?

Answer 1

➊ Uological emergency characterised by a prolonged, typically painful erection, which lasts > 2 hrs beyond sexual activity. This condition is not usually related to sexual desire or stimulation.

➋ Risk of irreversible damage to the penis

➌ * Ischaemic (low-flow) priapism - Most common type, caused by a lack of venous drainage from the corpora cavernosa. This form of priapism is related to hematologic disorders (like sickle cell disease), malignancies, or the use of certain drugs.
* Non-ischaemic (high-flow) priapism - Less common type, caused by unregulated arterial inflow. It’s often related to trauma.

Question 2

How is it managed?

Answer 2

1st line - Aspiration within the corpus cavernosa and irrigation with normal saline.
* If unsuccessful, intracavernosal injection of alpha agonists such as Adrenaline or Phenylephrine may be used
* A surgical shunt may be considered in refractory cases