Priapism
| Definition: prolonged and persistent penile erection lasting >4 hours, un-associated with sexual interest or stimulation People laugh about it, but it's compartment syndrome of the penis. |
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| Etiology | Low flow ischaemic (98% of presentations): - medications: hydralazine, CCBs, neuroleptics - cocaine, marijuana - Sickle cell disease, leukaemia High flow non-ischaemic (2%): fistula between cavernosal artery - trauma Stuttering = recurrent presentations of ischaemic priapism |
| Pathogenesis | |
| Clinical presentation | Ischaemic: painful |
| Diagnostic investigations | Cavernosal blood gas - acidotic in ischaemic priapism |
| Management | - Penile block - Aspiration 10-20ml cavernosal blood - between prox and middle 1/3, 10 o'clock and 2 o'clock with green butterfly needle - Intercavernosal phenylephrine |