Priapism: Current updates in clinical management

Priapism: Current updates in clinical management
adrenalin; baclofen; bicalutamide; diethylstilbestrol; digoxin; ephedrine; etilefrine; finasteride; ketoconazole; leuprorelin; metaraminol; methylene blue; noradrenalin; phenylephrine; phosphodiesterase inhibitor; pseudoephedrine; sildenafil; tadalafil; terbutaline; acidosis; angina pectoris; anorexia; anoxia; artificial embolism; blood pressure monitoring; corpus cavernosum; dizziness; drug megadose; dyspepsia; edema; erectile dysfunction; erosion; gynecomastia; headache; heart palpitation; heart rate; human; hypertension; infection; ischemia; liver toxicity; low drug dose; penile blood flow; penis disease; penis prosthesis; priapism; recurrent disease; restlessness; review; sexual dysfunction; sexual function; sexual health; shunting; tachycardia; treatment response; ureterolithotomy; urethra fistula; urethra injury
Issue Date
Korean Journal of Urology, v.54, no.12, pp.816 - 823
Priapism is a persistent penile erection that continues for hours beyond, or is unrelated to, sexual stimulation. Priapism requires a prompt evaluation and usually requires an emergency management. There are two types of priapism: 1) ischemic (veno-occlusive or low-flow), which is found in 95% of cases, and 2) nonischemic (arterial or high-flow). Stuttering (intermittent or recurrent) priapism is a recurrent form of ischemic priapism. To initiate appropriate management, the physician must decide whether the priapism is ischemic or nonischemic. In the management of an ischemic priapism, resolution should be achieved as promptly as possible. Initial treatment is therapeutic aspiration with or without irrigation of the corpora. If this fails, intracavernous injection of sympathomimetic agents is the next step. Surgical shunts should be performed in cases involving failure of nonsurgical treatment. The first management of a nonischemic priapism should be observation. Selective arterial embolization is recommended for the management of nonischemic priapism in cases that request treatment. The goal of management for stuttering priapism is prevention of future episodes. This article provides a review of recent clinical developments in the medical and surgical management of priapism and an investigation of scientific research activity in this rapidly developing field of study. ? The Korean Urological Association, 2013.
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