Abstract
Priapism is defined as a persistent erection of the penis not accompanied by sexual desire or stimulation, usually lasting more than 6 h and typically involving only the corpora cavernosa and resulting in dorsal penile erection with the ventral penis and glans being flaccid (Keoghane et al. 2002). Rare exceptions with involvement of the corpus spongiosum and sparing of the cavernosal spaces have been reported (Tarry et al. 1987). This condition has many different causes and in some cases can be a urological emergency. The recently published American Urological Association Guideline on the management of priapism sheds further light on the management of this potentially emergent condition, but the guideline does not establish a fixed set of rules or define the legal standard of care for the treatment of priapism (Montague et al. 2003).
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References
Al Jam’a AH, Al Dabbous IA (1998) Hydroxyurea in the treatment of sickle cell associated priapism. J Urol 159:1642
Baba H, Maezawa Y, Furusawa N, et al. (1995) Lumbar spinal stenosis causing intermittent priapism. Paraplegia 33:338–345
Bastuba MD, Saenz de Tejada I, Dinlenc CZ et al (1994) Arterial priapism: diagnosis, treatment and long-term followup. J Urol 151:1231–1237
Berger R, Billups K, Brock G et al (2001) Report of the American Foundation for Urologic Disease (AFUD) Thought Leader Panel for evaluation and treatment of priapism. Int J Impot Res 13[Suppl 5]:S39–43
Bertholon F, Krajewski Y, el Allali A (1996) [Adverse effects: priapism caused by paroxetine]. Ann Med Psychol (Paris) 154:145–146; discussion 146–147
Broderick GA, Gordon D, Hypolite J, Levin RM (1994) Anoxia and corporal smooth muscle dysfunction: a model for ischemic priapism. J Urol 151:259–262
Broderick GA, Harkaway R (1994) Pharmacologic erection: time-dependent changes in the corporal environment. Int J Impot Res 6:9–16
Burnett AL (2003) Pathophysiology of priapism: dysregulatory erection physiology thesis. J Urol 170:26–34
Carter RG, Thomas CE, Tomskey GC (1976) Cavernospongiosum shunts in treatment of priapism. Urology 7:292–295
Chan PT, Begin LR, Arnold D et al (1998) Priapism secondary to penile metastasis: a report of two cases and a review of the literature. J Surg Oncol 68:51–59
Daley JT, Brown ML, Watkins T et al (1996a) Prostanoid production in rabbit corpus cavernosum: I. regulation by oxygen tension. J Urol 155:1482–1487
Daley JT, Watkins MT, Brown ML et al (1996b) Prostanoid production in rabbit corpus cavernosum. II. Inhibition by oxidative stress. J Urol 156:1169–1173
De Stefani S, Savoca G, Ciampalini S et al (2001) Urethrocutaneous fistula as a severe complication of treatment for priapism. BJU Int 88:642–643
Dubin NN, Razack AH (2000) Priapism: ecstasy related? Urology 56:1057
Dutta JK (1992) Priapism in rabies. J Assoc Physicians India 40:555
Dutta JK (1994) Rabies presenting with priapism. J Assoc Physicians India 42:430
Ebbehoj J (1974) A new operation for priapism. Scand J Plast Reconst Surg 8:241–245
Eland IA, van der Lei J, Stricker BH, Sturkenboom MJ (2001) Incidence of priapism in the general population. Urology 57:970–972
Emond AM, Holman R, Hayes RJ, Serjeant GR (1980) Priapism and impotence in homozygous sickle cell disease. Arch Intern Med 140:1434–1437
Ercole CJ, Pontes JE, Pierce JM Jr (1981) Changing surgical concepts in the treatment of priapism. J Urol 125:210–211
Ewalt D, Cavender J, Buchanan G, Rogers Z (1996a) Characterization and incidence of priapism in boys with sickle cell anaemia. Paediatrics 88:643
Ewalt D, Cavender J, Buchanan G, Rogers Z (1996b) Leuprolide therapy prevents recurrent priapism in teenage boys with sickle cell anaemia. Paediatrics 88:610
Foda MM, Mahmood K, Rasuli P et al (1996) High-flow priapism associated with Fabry’s disease in a child: a case report and review of the literature. Urology 48:949–952
Friedman J (1998) Priapism: an unusual presentation of appendicitis. Pediatr Emerg Care 14:143–144
Jiva T, Anwer S (1994) Priapism associated with chronic cocaine abuse. Arch Intern Med 154:1770
Junemann K, Alken P (1989) Pharmacotherapy of erectile function: a review. Int J Impot Res 1:71–93
Keoghane SR, Sullivan ME, Miller MA (2002) The aetiology, pathogenesis and management of priapism. BJU Int 90:149–154
Kim N, Vardi Y, Padma-Nathan H et al (1993) Oxygen tension regulates the nitric oxide pathway. Physiological role in penile erection. J Clin Invest 91:437–442
Krco MJ, Jacobs SC, Lawson RK (1984) Priapism due to solid malignancy. Urology 23:264–266
Linet OI, Ogrinc FG (1996) Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. The Alprostadil Study Group. N Engl J Med 334:873–877
Lowe FC, Jarow JP (1993) Placebo-controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin E1-induced prolonged erections. Urology 42:51–53; discussion 53–54
Lue TF, Hellstrom WJ, McAninch JW, Tanagho EA (1986) Priapism: a refined approach to diagnosis and treatment. J Urol 136:104–108
Mantadakis E, Cavender JD, Rogers ZR et al (1999) Prevalence of priapism in children and adolescents with sickle cell anemia. J Pediatr Hematol Oncol 21:518–522
Martinez Portillo F, Hoang-Boehm J, Weiss J et al (2001) Methylene blue as a successful treatment alternative for pharmacologically induced priapism. Eur Urol 39:20–23
Miller ST, Rao SP, Dunn EK, Glassberg KI (1995) Priapism in children with sickle cell disease. J Urol 154:844–847
Montague DK, Jarow J, Broderick GA et al (2003) American Urological Association guideline on the management of priapism. J Urol 170:1318–1324
Mulhall JP, Honig SC (1996) Priapism: etiology and management. Acad Emerg Med 3:810–816
Nieminen P, Tammala T (1995) Aetiology of priapism in 207 patients. Eur Urol 28:241–245
O’Brien WM, O’Connor KP, Lynch JH (1989) Priapism: current concepts. Ann Emerg Med 18:980–983
Pohl J, Pott B, Kleinhans G (1986) Priapism: a three-phase concept of management according to aetiology and prognosis. Br J Urol 58:113–118
Porst H (1996) The rationale for prostaglandin E1 in erectile failure: a survey of worldwide experience. J Urol 155:802–815
Pryor J, Akkus E, Alter G et al (2004) Priapism. J Sex Med 1:116–120
Quigley M, Fawcett DP (1999) Thrombophilia and priapism. BJU Int 83:155
Ricciardi R, Jr., Bhatt GM, Cynamon J et al (1993) Delayed high flow priapism: pathophysiology and management. J Urol 149:119–121
Routledge PA, Shetty HG, White JP, Collins P (1998) Case studies in therapeutics: warfarin resistance and inefficacy in a man with recurrent thromboembolism, and anticoagulant-associated priapism. Br J Clin Pharmacol 46:343–346
Rutchik S, Sorbera T, Rayford RW, Sullivan J (2001) Successful treatment of recalcitrant priapism using intercorporeal injection of tissue plasminogen activator. J Urol 166:628
Schroeder-Printzen I, Vosshenrich R, Weidner W, Ringert RH (1994) Malignant priapism in a patient with metastatic prostate adenocarcinoma. Urol Int 52:52–54
Serjeant GR, de Ceulaer K, Maude GH (1985) Stilboestrol and stuttering priapism in homozygous sickle-cell disease. Lancet 2:1274–1276
Spycher MA, Hauri D (1986) The ultrastructure of the erectile tissue in priapism. J Urol 135:142–147
Steers WD, Selby JB, Jr (1991) Use of methylene blue and selective embolization of the pudendal artery for high flow priapism refractory to medical and surgical treatments. J Urol 146:1361–1363
Tarry WF, Duckett JW Jr, Snyder HM 3rd (1987) Urological complications of sickle cell disease in a pediatric population. J Urol 138:592–594
Vilke GM, Harrigan RA, Ufberg JW, Chan TC (2004) Emergency evaluation and treatment of priapism. J Emerg Med 26:325–329
Virag R, Bachir D, Lee K, Galacteros F (1996) Preventive treatment of priapism in sickle cell disease with oral and self-administered intracavernous injection of etilefrine. Urology 47:777–781; discussion 781
Winter CC (1978) Priapism cured by creation of fistulas between glans penis and corpora cavernosa. J Urol 119:227–228
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Liguori, G., Bucci, S., Benvenuto, S., Trombetta, C., Belgrano, E. (2008). Pathophysiology and Treatment of Priapism. In: Bertolotto, M. (eds) Color Doppler US of the Penis. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-36677-5_9
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