Priapism

Priapism is rare and is a medical emergency. Ischaemic priapism is the commonest subtype with haematological abnormalities, psychotropic or recreational drug use and malignancy being the other common aetiologies. Emergency decompression of this compartment syndrome is required to preserve cavernosal smooth muscle function and this should ideally be performed as soon as possible. The degree of resultant erectile dysfunction is related to the duration of the priapism. Non-ischaemic priapism is an unregulated inflow of arterial blood, often as a result of perineal trauma and a lacerated cavernosal vessel. Selective arterial embolization should be performed and results are usually excellent. The final subtype is stuttering priapism, the cause of which is often unknown and a variety of methods will be discussed for its treatment.