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Acute management of priapism in men
journal contribution
posted on 2024-03-26, 04:30 authored by Yeng K Tay, Daniel Spernat, Kathryn Rzetelski‐West, Sree Appu, Chris LoveUNLABELLED: What's known on the subject? and What does the study add? Priapism is a rare event. However, various medications and medical conditions may increase the risk. Priapism can be ischaemic, non-ischaemic or stuttering. It is paramount to distinguish the type of priapism, as misdiagnosis may lead to significant morbidity. Ischaemic priapism represents a compartment syndrome of the penis and is therefore a medical emergency. A delay in management may significantly affect future erectile function. Stuttering priapism represents recurrent subacute episodes of ischaemic priapism, which may lead to erectile dysfunction. Thus episodes must be minimised. Non-ischaemic priapism is not a medical emergency. However, misdiagnosis and injection with sympathomimetic agents can result in system absorption and toxicity. This review article provides a summary of the evaluation and management of priapism. Furthermore, a step by step flow chart is provided to guide the clinician through the assessment and management of this complex issue. OBJECTIVES: To review the literature regarding ischaemic, non-ischaemic and stuttering priapism. To provide management recommendations. PATIENTS AND METHODS: A Medline search was carried out to identify all relevant papers with management guidelines for priapism. RESULTS: Ischaemic priapism represents a compartment syndrome of the penis and urgent intervention is required to decrease the risk of erectile dysfunction. Non-ischaemic priapism is not a medical emergency; however, it can result in erectile dysfunction. The treatment objective for stuttering priapism is to reduce future episodes with systemic treatments, whilst treating each ischaemic episode as an emergency. CONCLUSIONS: Priapism is a complex condition that requires expert care to prevent complications and irreversible erectile dysfunction.
History
Journal
BJU InternationalVolume
109Pagination
15-21Location
EnglandPublisher DOI
ISSN
1464-4096eISSN
1464-410XLanguage
enPublication classification
C1.1 Refereed article in a scholarly journalIssue
s3Publisher
WileyUsage metrics
Keywords
Disease ManagementHumansInjectionsMalePhysical Therapy ModalitiesPriapismSympathomimeticsTreatment OutcomeUrologic Surgical Procedures, MaleScience & TechnologyLife Sciences & BiomedicineUrology & Nephrologypriapismerectile dysfunctionpenile prosthesisSICKLE-CELL-DISEASEHIGH-FLOW PRIAPISMAUTOLOGOUS CLOT EMBOLIZATIONPENILE PROSTHESISPHENYLEPHRINEPATHOGENESISINSERTIONSHUNTUrologic DiseasesClinical Research
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