Erections lasting longer than 4-6 hours are associated with permanent erection problems. It has been estimated that priapism of 24 hours duration is associated with an approximately 50% incidence of permanent erectile dysfunction. When such a patient presents to their physician's office or the emergency department, a urologist should be notified immediately and urgent steps should be taken to initiate evaluation and treatment. The most important step in evaluating and treating a man with priapism is differentiating between ischemic and non-ischemic priapism.
The patient with ischemic priapism typically complains of a painful erection, which is fully rigid. Men with non-ischemic priapism have an erection that is usually less than fully rigid and painless. The latter patient routinely gives a history of some form of penile or perineal trauma.
A comprehensive history and physical exam should be performed. A history should focus on possible causes, including the use of prescription, erectogenic or recreational drugs. Formal laboratory testing routinely includes peripheral blood tests, a urine toxicology screen and a blood gas analysis of the penile blood (corporal blood). Analysis of penile blood gas is paramount in differentiating between ischemic and non-ischemic priapism. Additionally, if the initial evaluation of a man with ischemic priapism is negative, a workup for hematologic malignancies (leukemia, multiple myeloma) or blood dyscrasias (sickle cell disease, thalassemia, and glucose-6-phosphate dehydrogenase) may be undertaken. Occasionally, a penile doppler ultrasound may be used to assess for the presence or absence of penile blood flow and to locate the possible location of a fistula.
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You can find the office contact information for each physician specializing in Priapism by visiting their profile listed on the bottom of this webpage.
If you'd like to learn more about our providers that specialize in Priapism, please review the Physicians & Faculty profiles listed at the bottom of this page