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Urology 2020 Apr 17. 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

Urologe A 2015 Nov;54(11):1631-9; quiz 1640-1

Klinik für Urologie, Andrologie und Kinderurologie, Klinikum Weiden/Kliniken Nordoberpfalz AG, Söllnerstr. 16, 92637, Weiden, Deutschland.

Priapism is characterized by involuntary persistent penile erection after or independent of sexual stimulation. The diagnostic clarification, including patient history, physical findings, duplex ultrasonography and analysis of blood gases is decisive for the underlying pathophysiology and the appropriate therapeutic procedure. Non-hypoxic and non-acidotic blood gas parameters enable a conservative approach, hypoxic, hypercarbic and acidotic parameters may lead to fibrosis of the corpora cavernosa and, in turn, to a loss of penile function. Read More

Nat Rev Urol 2015 Nov 20;12(11):607-16. Epub 2015 Oct 20.

Department of Urology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark.

Normal fertility is dependent on intravaginal delivery of semen through ejaculation. This process is highly dependent on an intact ejaculatory reflex arc, which can be disrupted through any type of trauma or disease causing damage to the CNS and/or peripheral nerves. Neurogenic anejaculation is most commonly associated with spinal cord injury. Read More

Acta Cir Bras 2015 Aug;30(8):529-36

Department of Surgery, UNIFESP, São Paulo, SP, BR.

Purpose: To compare the reconstruction of corpus cavernosum segments when seeded with mesenchymal stem cells and when stem cells are infused intravenously.

Methods: Sixteen New Zealand rabbits were submitted to reconstruction of the corpus cavernosum and distributed in Group A - decellularized matrices, Group B - decellularized matrices seeded with mesenchymal stem cells Group C - decellularized matrices submitted to intravenous infusion of mesenchymal stem cells. The mesenchymal stem cells were obtained by bone marrow aspiration. Read More

Mil Med 2015 Jul;180(7):e853-7

Department of Emergency Medicine, Bayne Jones Army Community Hospital, 1585 3rd Street, Fort Polk, LA 71459.

We report the case of a 21-year-old active duty U.S. Army soldier with painful and nonresolving priapism following blunt pelvic and lower extremity trauma from military static-line parachute injury during training. Read More

Urologe A 2015 May;54(5):654-61

Klinik für Urologie, Kliniken Maria Hilf, Viersener Str. 450, 41063, Mönchengladbach, Deutschland,

Priapism is defined as an erection for more than 4 h without sexual stimulation. The most common form with nearly 95% is the ischemic or low-flow form, which is very painful. The other 5% are comprised of nonischemic high-flow type usually caused by a blunt perineal trauma and the recurrent or intermittent so-called stuttering priapism. Read More

Ther Adv Urol 2014 Dec;6(6):230-44

The James Buchanan Brady Urological Institute, Johns Hopkins Hospital, 600 North Wolfe Avenue, Marburg 405, Baltimore, MD 21287, USA.

Priapism is a prolonged erection that persists beyond or is unrelated to sexual stimulation. It is associated with significant morbidity: psychological, socioeconomic, and physical, including pain and potentially irreversible compromise of erectile function. There are three major types of priapism: ischemic, nonischemic, and stuttering. Read More

Urol Ann 2014 Oct;6(4):366-8

Department of Surgery, Division of Urology, King Khalid University Hospital, King Saud University, Kingdom of Saudi Arabia.

Priapism is a well-known cause of erectile dysfunction. There are a wide variety of causes, including hemoglobinopathy, neurological diseases, and drugs. We present a case report of an Asian man who presented with priapism that was continuous for 3 days after taking three doses of pregabalin for chronic back pain. Read More

J Sex Med 2015 Jan 27;12(1):259-64. Epub 2014 Oct 27.

Department of Urology, Rush University Medical Center, Chicago, IL, USA.

Introduction: Collagenase clostridium histolyticum (CCH) is an Food and Drug Administration-approved intralesional injection for treatment of Peyronie's disease (PD) that has been shown to reduce penile curvature deformity and PD symptom bother in phase 2b and phase 3 placebo-controlled clinical trials. For some patients, nonsurgical treatment with CCH may not sufficiently improve penile curvature, and surgical correction may be pursued following CCH therapy.

Aim: This study aims to examine intraoperative and postsurgical outcomes of surgical correction of persistent penile curvature in patients with PD who had previously received CCH. Read More

West J Emerg Med 2014 Feb;15(1):114-6

Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Priapism is rarely related to use of non-erectile related medications. The objective was to educate about the multiple possible causes of priapism and to provide treatment recommendations for the different types of priapism. We present the case of a 43-year-old African American male with a history of schizoaffective disorder who presented to our emergency department multiple times over a three year period with priapism, each episode related to the ingestion of quetiapine. Read More

Korean J Urol 2013 Dec 10;54(12):816-23. Epub 2013 Dec 10.

Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.

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). Read More

Eur Urol 2014 Feb 16;65(2):480-9. Epub 2013 Nov 16.

2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address:

Context: Priapism is defined as a penile erection that persists beyond or is unrelated to sexual interest or stimulation. It can be classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent or intermittent).

Objective: To provide guidelines on the diagnosis and treatment of priapism. Read More

Prog Urol 2013 Jul 15;23(9):638-46. Epub 2013 Jun 15.

Service d'urologie andrologie, université Montpellier 1, CHU Carémeau, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France. Ele

Objectives: Priapism is a rare condition for which urgent diagnosis and treatment is required. This paper reviews the literature regarding ischaemic, non-ischaemic and stuttering priapism in order to provide management recommendations.

Methods: A Medline search was carried out to identify all relevant papers with management guidelines for priapism and combined with expert opinion of the authors. Read More

Spinal Cord 2013 Aug 21;51(8):642-4. Epub 2013 May 21.

IVF and Andrology Units, Urology and Rehabilitation Department, The Chaim Sheba Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv), Tel Hashomer, Israel.

Study Design: Retrospective cohort analysis.

Objectives: The objective of this study was to determine the in vitro fertilization (IVF) outcome after testicular sperm extraction (TESE) in a group of spinal cord injury (SCI) male patients not compatible with conservative fertility treatment.

Setting: University-affiliated medical center. Read More

J Sex Med 2013 Jan 29;10(1):180-94. Epub 2012 Mar 29.

Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Aim: To provide standard operating procedures for the diagnosis and management of priapism.

Methods: Review of the literature.

Main Outcome Measures: Reduction of priapism and preservation of erectile function. Read More

Minim Invasive Ther Allied Technol 2012 Sep 5;21(5):366-8. Epub 2011 Dec 5.

Department of Urology, Ninewells Hospital and Dundee Medical School, Dundee, Scotland, UK.

Priapism is an urological emergency with detrimental consequences, if not managed expeditiously. Though a rare condition with an incidence between 0.3 and 1. Read More

J Androl 2012 Jul-Aug;33(4):566-9. Epub 2011 Oct 6.

Department of Surgery, Faculty of Medicine, King Saud University, PO Box 36175, Riyadh, 1149, Saudi Arabia.

High-flow priapism most often occurs following perineal and penile trauma. We report the case of a 29-year-old man who presented with recurrent priapism and was initially treated with corporal aspiration and intracavernosal injections on multiple emergency department visits and then condition-controlled with sibutramine while on treatment for weight loss. His condition relapsed after the medication was withdrawn from the market, necessitating medical intervention. Read More

J Sex Med 2012 Jan 23;9(1):88-103. Epub 2011 Jun 23.

Department of Urology, Mayo Clinic, FL 32224, USA.

Introduction: Priapism describes a persistent erection lasting longer than 4 hours. Ischemic priapism and stuttering priapism are phenotypic manifestations of sickle-cell disease (SCD).

Aims: To define the types of priapism associated with SCD, to address pathogenesis, and to recommend best practices. Read More

Indian J Dermatol Venereol Leprol 2011 Jan-Feb;77(1):47-50

Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India.

A 55-year-old male with carcinoma in situ of urinary bladder was treated with weekly intravesical injections of Bacillus Calmette Guerin (BCG) vaccine. Three days after the sixth injection, he developed low grade fever and multiple grouped punched out, 2-3 mm ulcers around meatus and corona glandis. In addition, multiple, firm, indurated, nontender papules and few deeper nodules were present on the proximal part of glans penis, along with bilateral enlarged, matted and nontender inguinal lymph nodes. Read More

Urology 2010 Aug;76(2 Suppl 1):S15-23

Department of Urology, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa.

A comprehensive literature study was conducted to evaluate the levels of evidence (LEs) in publications on the diagnosis and staging of penile cancer. Recommendations from the available evidence were formulated and discussed by the full panel of the International Consultation on Penile Cancer in November 2008. The final grades of recommendation (GRs) were assigned according to the LEs of the relevant publications. Read More

Andrologia 2010 Feb;42(1):1-4

Department of first Urology, Ataturk Teaching and Research Hospital, Bilkent, Ankara, Turkey.

Penile color Doppler sonography is a valuable method for evaluating erectile dysfunction. However, there are some concerns about the safety of this method due to the intracorporeal pharmacological injection, which may cause priapism as a complication, resulting in penile fibrosis. To evaluate the actual incidence of papaverine-induced priapism in patients with erectile dysfunction (ED) who underwent penile colour Doppler sonography and to determine the safety of this diagnostic tool, a retrospective study was conducted using the database of our institution. Read More

Urology 2010 Jan 6;75(1):71-2. Epub 2009 Nov 6.

Nepean Private Hospital, Kingswood NSW.

A 51-year-old man presented with 4 days of idiopathic ischemic priapism. Partial detumescence was achieved with aspiration and injection with intracorporeal adrenaline. On further evaluation, the patient was diagnosed with thrombotic thrombocytopenic purpura. Read More

Top Companion Anim Med 2009 May;24(2):49-54

Animal Care Center, Rohnert Park, CA, USA.

Priapism is a persistent penile erection lasting longer than 4 hours, without sexual stimulation. Priapism is categorized as either nonischemic (arterial, high flow) or ischemic (veno-occlusive, low flow). Ischemic priapism is considered an emergency in people. Read More

Nat Rev Urol 2009 May;6(5):262-71

Department of Urology, University of California, San Francisco, CA 94143, USA.

Priapism is defined as a persistent penile erection (typically 4 h or longer) that is unrelated to sexual stimulation. Priapism can be classified as either ischemic or nonischemic. Ischemic priapism, the most common subtype, is typically accompanied by pain and is associated with a substantial risk of subsequent erectile dysfunction. Read More

J Urol 2009 Apr 23;181(4):1699-705. Epub 2009 Feb 23.

Northstar Urology, Vail, Colorado.

Purpose: Conservative management of prolonged ischemic priapism is rarely effective. Interventions include corporal aspiration/irrigation, injection of vasoconstrictive agents or surgical procedures. We describe a technique that fulfills several important criteria in the surgical management of ischemic priapism in that immediate resolution of ischemic pain is achieved, a wide area, reliably patent shunt is created, the procedure is technically simple and it may be performed with the patient under a local anesthetic. Read More

J Pak Med Assoc 2008 Dec;58(12):701-2

Department of Haematology, Sultan Qaboos University Hospital, Sultanate of Oman.

We report the case of a young Omani man, a regular blood donor, who presented twice in two months, with painful penile erection lasting more than 12 hours. The patient is known to have sickle cell trait [HbS 34.6%]. Read More

Prog Urol 2008 Nov 10;18(10):669-73. Epub 2008 Jun 10.

Service urologie-andrologie, centre hospitalier régional La Source, B.P. 6709, 45067 Orléans cedex 2, France.

Introduction: Ischemic (veno-occlusive, low flow) priapism is a painful and persistent penile erection unrelated to sexual desire or stimulation. In some cases, it is an adverse event of antipsychotic medications.

Material: Between 1st January 2000 and 30th September 2007, four men (range 25/55 years), treated with antipsychotic agents (amisulpride, clozapine, levomepromazine, olanzapine, pipotiazine, risperidone or zuclopenthixol), presented one or several episodes of ischemic priapism. Read More

Zhonghua Nan Ke Xue 2007 Jun;13(6):535-7

Department of Urology, General Hospital of PLA, Beijing 100853, China.

Objective: To explore the diagnosis and treatment of veno-occlusive priapism.

Methods: The diagnosis and treatment of 17 cases of veno-occlusive priapism were analyzed retrospectively.

Results: All the 17 patients were evaluated by physical examination, cavernous blood gas analysis and color Doppler ultrasonography, and treated by conservative therapy, intracavernosal aspiration and injection, surgical operation. Read More