5-Minute Emergency Consult
Priapism
Priapism is a topic covered in the 5-Minute Emergency Consult.
To view the entire topic, please log in or purchase a subscription.
Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
Description
Description
- Penile erection (engorgement of corpora cavernosa) in the absence of sexual arousal that is prolonged and frequently painful
- Low-flow priapism:
- Most common mechanism
- Poor venous outflow
- Usually painful
- Ischemia and thrombosis from stagnant, hypoxic blood can occur after a few hours
- Fibrosis and erectile dysfunction are late sequelae
- High-flow priapism:
- Rare
- Penile arterial laceration with uncontrolled inflow of arterial blood
- Usually painless
- Presentation may be later than in low-flow priapism
- Ischemia and erectile dysfunction are uncommon
Etiology
Etiology
- Idiopathic
- Pharmacologic agents:
- Intracavernosal injectables for the treatment of erectile dysfunction:
- Prostaglandin E1
- Papaverine
- Phentolamine
- Psychotropics:
- Phenothiazines
- Butyrophenones
- Trazodone
- Sedative–hypnotics
- Selective serotonin uptake inhibitors
- Antihypertensives:
- Prazosin
- Hydralazine
- Phenoxybenzamine
- Guanethidine
- Rarely implicated agents:
- Phosphodiesterase inhibitors: Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra)
- Anticoagulants
- Cocaine
- Marijuana
- Ethanol
- Androstenedione
- Toxins (Black Widow, scorpion)
- Intracavernosal injectables for the treatment of erectile dysfunction:
- Hematologic disorders predisposing to sludging of blood:
- Sickle cell anemia (most common cause)
- Leukemia
- Multiple myeloma
- Polycythemia
- Penile and perineal trauma (arterial laceration and high-flow priapism)
- Spinal trauma (loss of inhibitory adrenergic tone)
- Rare causes:
- Pelvic neoplasms and infections
- Infiltrative diseases (e.g., amyloidosis)
- Dialysis
- Parenteral nutrition solutions containing a fat emulsion
Pediatric Considerations
Sickle cell anemia is the cause of most priapism in children
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
Description
- Penile erection (engorgement of corpora cavernosa) in the absence of sexual arousal that is prolonged and frequently painful
- Low-flow priapism:
- Most common mechanism
- Poor venous outflow
- Usually painful
- Ischemia and thrombosis from stagnant, hypoxic blood can occur after a few hours
- Fibrosis and erectile dysfunction are late sequelae
- High-flow priapism:
- Rare
- Penile arterial laceration with uncontrolled inflow of arterial blood
- Usually painless
- Presentation may be later than in low-flow priapism
- Ischemia and erectile dysfunction are uncommon
Etiology
Etiology
- Idiopathic
- Pharmacologic agents:
- Intracavernosal injectables for the treatment of erectile dysfunction:
- Prostaglandin E1
- Papaverine
- Phentolamine
- Psychotropics:
- Phenothiazines
- Butyrophenones
- Trazodone
- Sedative–hypnotics
- Selective serotonin uptake inhibitors
- Antihypertensives:
- Prazosin
- Hydralazine
- Phenoxybenzamine
- Guanethidine
- Rarely implicated agents:
- Phosphodiesterase inhibitors: Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra)
- Anticoagulants
- Cocaine
- Marijuana
- Ethanol
- Androstenedione
- Toxins (Black Widow, scorpion)
- Intracavernosal injectables for the treatment of erectile dysfunction:
- Hematologic disorders predisposing to sludging of blood:
- Sickle cell anemia (most common cause)
- Leukemia
- Multiple myeloma
- Polycythemia
- Penile and perineal trauma (arterial laceration and high-flow priapism)
- Spinal trauma (loss of inhibitory adrenergic tone)
- Rare causes:
- Pelvic neoplasms and infections
- Infiltrative diseases (e.g., amyloidosis)
- Dialysis
- Parenteral nutrition solutions containing a fat emulsion
Pediatric Considerations
Sickle cell anemia is the cause of most priapism in children
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Schaider, Jeffrey J., et al., editors. "Priapism." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307457/all/Priapism.
Priapism. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307457/all/Priapism. Accessed April 1, 2023.
Priapism. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307457/all/Priapism
Priapism [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 April 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307457/all/Priapism.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Priapism
ID - 307457
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307457/all/Priapism
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -
