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Pediatrics 2022 06;149(6)

Departments of Urology.

Although rare in pediatrics, ischemic priapism carries significant risk of erectile dysfunction if not treated promptly. We report a case of idiopathic ischemic priapism in a male aged 14 years, refractory to traditional therapies, including aspiration/irrigation, phenylephrine injection, and distal shunt. However, the priapism resolved after intracavernosal injections of tissue plasminogen activator (tPA) with preservation of normal erectile function. Read More

J Urol 2021 Nov 8;206(5):1114-1121. Epub 2021 Sep 8.

Northwestern University, Chicago, Illinois (Vice Chair).

Purpose: Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given its time-dependent and progressive nature, priapism is a situation that both urologists and emergency medicine practitioners must be familiar with and comfortable managing. Acute ischemic priapism, characterized by little or no cavernous blood flow and abnormal cavernous blood gases (ie, hypoxic, hypercarbic, acidotic) represents a medical emergency and may lead to cavernosal fibrosis and subsequent erectile dysfunction. Read More

Encephale 2021 Oct 17;47(5):502-503. Epub 2020 Dec 17.

Emergencies' Department of Military Hospital of Rabat, Mohamed V University of Rabat, Rabat, Morocco.

Priapism is classically defined as a partial or complete erection, abnormally prolonged in the absence of desire or sexual stimulation. Several classes of drugs as well as certain psychoactive substances (e.g. Read More

Am J Emerg Med 2021 Jan 18;39:251.e5-251.e7. Epub 2020 Jun 18.

Intensive Care department, Centre Hospitalier de Versailles - Site André Mignot, Le Chesnay, France; University Paris-Saclay, UVSQ, INSERM, CESP, Team "PsyDev", Villejuif, France. Electronic address:

Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability. Read More

Syst Biol Reprod Med 2020 Dec 27;66(6):355-363. Epub 2020 Jul 27.

The First Affiliated Hospital of Xi'an Jiao Tong University , Xi'an, Shaanxi, China.

Male diabetes mellitus (DM) can affect erectile function and sperm quality. In severe cases, DM can lead to retrograde or no ejaculation, so testicular sperm aspiration (TESA) is combined with intracytoplasmic sperm injection (ICSI) to treat subfertility and infertility for DM couples. However, the effect of TESA upon ICSI (TESA-ICSI) for DM patients remains unclear. Read More

J Urol 2020 Nov 9;204(5):1033-1038. Epub 2020 Jun 9.

Department of Urology, Jackson Memorial Hospital and University of Miami Miller School of Medicine, Miami, Florida.

Purpose: Ischemic priapism is a urological emergency that requires prompt intervention to preserve erectile function. Characteristics that influence escalation to surgical intervention remain unclear. We identified factors and developed machine learning models to predict which men presenting with ischemic priapism will require shunting. Read More

Urology 2020 07 17;141:82-88. Epub 2020 Apr 17.

Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy.

Objective: To evaluate semen characteristics and reproductive outcomes after assisted ejaculation methods with fresh in vitro fertilization/intracytoplasmic sperm injection cycles in patients suffering from spinal cord injury (SCI), compared to controls, affected by idiopathic male infertility (non-SCI group).

Methods: SCI patients first underwent penile vibratory stimulation. Men "non-responders" to penile vibratory stimulation underwent electroejaculation. Read More

Urologiia 2019 Dec(5):112-113

Institute of Uronephrology and Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

Blood disorders, in particular chronic myeloid leukemia (CML), are among the rare etiological factors of priapism. A clinical observation of ischemic priapism lasting 18 hours, which developed in patients with previously not diagnosed CML, is presented in the article. The CML was subsequently diagnosed based on the results of blood analyses and bone marrow aspiration. Read More

Hinyokika Kiyo 2019 Jul;65(7):315-317

The Department of Urology, Nagano Municipal Hospital.

A 71-year-old man visited a local urologist with the complaint of continuous painful erection for three days. Penile cavernosal blood data showed acidosis and hypoxia. Thus he was diagnosed with ischemic priapism. Read More

J Surg Case Rep 2019 Apr 6;2019(4):rjz108. Epub 2019 Apr 6.

Department of Urology, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.

A cavernosal abscess is a rare condition. It can be idiopathic or with an underlying cause such as intracavernosal injection therapy, foreign bodies, perineal abscesses extension, priapism or trauma. The most common presenting symptoms were penile pain and swelling. Read More

BMJ Case Rep 2019 Feb 21;12(2). Epub 2019 Feb 21.

Urology, Glasgow Royal Infirmary, Glasgow, UK.

Melanocortin analogues, such as melanotan, are illegally used for artificial tanning. They have also been suggested as possible therapeutic agents in the treatment of erectile dysfunction. This case study presents a patient attending the accident and emergency department, in a tertiary urology centre, with acute priapism after abdominal subcutaneous injection of melanotan. Read More

Sex Med Rev 2019 04 28;7(2):283-292. Epub 2018 Nov 28.

Department of Urology, Tulane University, New Orleans, LA, USA. Electronic address:

Background: Priapism has been linked to many commonly prescribed medications, as well as recreational drugs and toxins. Although the incidence of priapism as a result of medication is small, the increasing use of antidepressants, antipsychotics, and recreational drugs may lead to more cases of pharmacologically-induced priapism in the future.

Aim: To provide a comprehensive, up-to-date review of the most common causes of pharmacologically induced priapism and discuss incidence, pathophysiology, and basic management strategies. Read More

Prog Urol 2018 Nov 7;28(14):772-776. Epub 2018 Sep 7.

Department of Urology, Pitié Salpétrière Hospital, Sorbonne Université, 47-83 boulevard de l'Hôpital, 75013 Paris, France. Electronic address:

Objective: Our aim was to present a synthesis on the diagnosis and treatment of priapism.

Methods: For this purpose, a literature search was performed through PubMed to analyze literature reviews and guidelines regarding priapism.

Results: Priapism is an erection that persists more than 4hours. Read More

Cureus 2018 Jun 7;10(6):e2758. Epub 2018 Jun 7.

Graduate Medical Education, Florida Hospital-Orlando, Orlando, USA.

Priapism, a persistent erection of the penis which has no association with sexual activity and lasts longer than four hours, is a urologic emergency. It can be classified into ischemic, nonischemic, and stuttering categories. The pathophysiology of stuttering priapism is not well understood; however, the dysregulation of nitric oxide and phosophodiesterase-5 (PDE5) has been put forward as a possible mechanism. Read More

Simul Healthc 2017 Dec;12(6):407-413

From the Department of Emergency Medicine, Christiana Care Health System, Newark, DE.

Introduction: Priapism is a rare yet time sensitive emergency with potentially significant morbidity. A novel task trainer was developed for corpus cavernosa aspiration and phenylephrine injection. The primary aim of this study was to assess model realism and usefulness for emergency medicine resident procedural education. Read More

Res Rep Urol 2017 29;9:175-179. Epub 2017 Aug 29.

Department of Urology, University of Turin, Città della Salute e della Scienza, Turin, Italy.

Objectives: The aim of the present manuscript is to review the current literature on priapism, focusing on the state-of-the-art knowledge of both the diagnosis and the treatment of the refractory ischemic priapism (IP).

Methods: Pubmed and EMBASE search engines were used to search for words "priapism", "refractory priapism", "penile prosthesis", "diagnosis priapism", "priapism treatment", "penile fibrosis", "priapism therapy". All the studies were carefully examined by the authors and then included in the review. Read More

Emerg Med Pract 2017 Jan 22;19(1 Suppl Points & Pearls):S1-S2. Epub 2017 Jan 22.

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. Read More

Aktuelle Urol 2017 Sep 16;48(5):469-472. Epub 2017 May 16.

Priapism is a prolonged erection without sexual stimulation. In most cases it requires prompt management in order to avoid long-term consequences such as erectile dysfunction or penile deformity. Priapism is rare in children, but haematological diseases play an important role. Read More

J Emerg Med 2017 Jun 22;52(6):859-862. Epub 2017 Mar 22.

Section of Emergency Medicine, University of Chicago, Chicago, Illinois.

Background: Recurrent priapism secondary to sickle cell trait in an African-American male has been reported in the literature. A common treatment for these low-flow priapism cases is aspiration and injection of the corpus cavernosum with a sympathomimetic agent. We report a rare complication not described previously in the literature of ST-elevation myocardial infarction (STEMI) and cardiogenic shock in a 29-year-old male with sickle cell trait undergoing a routine detumescence procedure. Read More

Emerg Med Pract 2017 Jan 1;19(1):1-16. Epub 2017 Jan 1.

Assistant Professor, Section of Emergency Medicine, Department of Medicine, University of Chicago, Chicago, IL.

Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. Read More

J Sex Med 2016 11 28;13(11):1704-1707. Epub 2016 Sep 28.

Boston Medical Center, Boston, MA, USA.

Introduction: Ischemic priapism is an uncommon urologic emergency characterized by a compartment syndrome-like ischemic insult to the corpora cavernosa of the penis. The goal of treatment in ischemic priapism is rapid detumescence to prevent long-term erectile dysfunction. Non-surgical treatment options include aspiration, irrigation, and intracavernous injections of sympathomimetic agents. Read More

Urology 2017 Dec 28;110:220-222. Epub 2016 Sep 28.

Cohen Children's Medical Center, Lake Success, NY.

We present the first reported case of refractory pediatric priapism treated by intracavernosal tunneling T shunt. A 12-year-old male, with sickle cell disease, presented with 72 hours of painful erection. The patient failed conservative measures including aspiration, injection of phenylephrine, as well as distal shunt procedure. Read More

Sex Med Rev 2017 Jan 26;5(1):120-128. Epub 2016 Sep 26.

Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address:

Introduction: Priapism, taking its name from God Priapus, is total or partial erection lasting longer than 4 hours independent of sexual stimulus and can result in erectile dysfunction. There are three subtypes of priapism.

Aim: To review the three subtypes of priapism, their pathophysiology, current treatment options, and complications. Read More

Urol Ann 2016 Apr-Jun;8(2):193-6

Department of Surgery, Division of Urology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.

Objectives: Intracorporeal injections (ICIs) of vasoactive substances during penile Doppler ultrasound (PDU) are a common investigation for erectile dysfunction (ED) diagnosis. ICI can be responsible of priapism, a pathological condition of prolonged penile erection not related to sexual stimulation. The aim of our study is to investigate the effectiveness of physical exercise and medical treatment as noninvasive therapy to restore detumescence in prolonged erections after ICI. Read More

Springerplus 2016 12;5:436. Epub 2016 Apr 12.

State Key Laboratory of Reproductive Medicine, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 People's Republic of China.

Introduction: Priapism is an uncommon disorder of involuntary prolonged erection beyond sexual excitement or desire. Herein, we present a rare case of priapism resulting from traditional circumcision under regional anesthesia with dorsal penile nerve block by xylocaine, which was successfully treated by intracavernosal injection of metaraminol bitartrate.

Case Description: A 37-year-old man visited our out-patient department for a penile erection, which had been observed during the surgery, lasting for 21 days. Read More

Indian J Urol 2016 Jan-Mar;32(1):57-60

Department of Pathology, Cancer Institute (WIA), Adyar, Chennai, India.

Introduction: We aimed to evaluate the role of dynamic sentinel node biopsy (DSLNB) in patients diagnosed with carcinoma penis and clinically N0 disease using superficial inguinal dissection as the standard staging modality.

Materials And Methods: Twenty consecutive men (40 groins) with carcinoma penis having clinically N0 status were enrolled in the study. Patients underwent DSLNB if fine needle aspiration cytology from the groin nodes was negative, followed by injection of radiocolloid and blue dye. Read More

Urol Ann 2016 Jan-Mar;8(1):46-50

Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.

Introduction: Priapism has a devastating consequence on the sexual function of men if not promptly managed. We are presenting our experience of the treatment of priapism and the status of sexual function even following successful detumescence achieved after treatment.

Materials And Methods: Nineteen patients, who presented with priapism from January 2012 to December 2014, were included in the study. Read More

Am J Emerg Med 2016 Feb 24;34(2):222-4. Epub 2015 Oct 24.

Emergency Medicine, Trinity Mother Frances Hospital, Tyler, TX.

Background: Ischemic priapism is the most common cause of priapism due to low blood flow. Current guidelines recommend penile aspiration and the use of intracavernous injection of vasoactive agents. The data to support these recommendations are limited and rely on expert consensus. Read More