Priapismes

Abstract

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. A Medline search was carried out to identify all relevant papers with management guidelines for priapism and combined with expert opinion of the authors. Ischaemic priapism represents a compartment syndrome of the penis and urgent intervention is required to decrease the risk of erectile dysfunction. First line treatment is medical and associate cavernosal blood aspiration and sympathomimetic intracavernosal injection. Second line treatment is surgical by creating a cavernospongious shunt. Non-ischaemic priapism is not a medical emergency; however, it may need embolization of the arteriocavernosal fistula and result in erectile dysfunction. The treatment objective for stuttering priapism is to decrease episodes of prolonged erections with systemic treatments, while treating each acute episode as an emergency. Priapism is a potentially severe condition that requires urgent diagnosis and well-defined sequential management to prevent treatment delay, complications and irreversible erectile dysfunction.