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priapism
Persistent erection of the penis (> 2 hours).
Etiology:
- sickle cell anemia
- pharmaceuticals
- trazodone (most common) < 0.1%
- antipsycotics
- anticoagulants
- antihypertensives
Pathology:
- results from pathologic condition, rather than any sexual desire
Clinical manifestations:
1) pain
2) tenderness
Laboratory:
- complete blood count for leukocytosis, anemia, or thrombocytosis
- reticulocyte count for patients with sickle cell anemia
- hemoglobin electrophoresis if sickle cell anemia suspected
- urine toxicology useful only if medications suspected as cause [3]
Radiology:
- ultrasound
- penile angiography if high-flow priapism to confirm fistulas identified by ultrasound [3]
Management:
- intravenous fluids
- adequate oxygenation
- pain control
- urgent urologic consultation
- local aspiration
- irrigation
- unproven therapies
- pseudoephedrine
- beta-2 receptor agonists: albuterol
- alpha-blockers
- erythrocyte transfusion (sickle cell disease)
General
sign/symptom
penile disorder
References
- Stedman's Medical Dictionary 27th ed, Williams &
Wilkins, Baltimore, 1999
- Medical Knowledge Self Assessment Program (MKSAP) 16,
American College of Physicians, Philadelphia 2012
- Schwartz B
Fast Five Quiz: Penis Conditions and Disorders
Medscape. Nov 29, 2022
https://reference.medscape.com/viewarticle/984322
- Fantus RJ, Brannigan RE, Davis AM.
Diagnosis and Management of Priapism
JAMA. Published online July 20, 2023
PMID: 37471069
https://jamanetwork.com/journals/jama/fullarticle/2807698