Priapism is defined as a penile erection lasting longer than 4 hours without sexual stimulation / excitation.

There are 3 types of priapism: low flow (ischemic), high flow (nonischemic), and stuttering (recurrent):

• Ischemic priapism is the most common and serious type of priapism. It is characterized by a prolonged, painful erection due to reduced or blocked blood flow. This can cause tissue damage and is a medical emergency that requires prompt treatment.
• Nonischemic priapism is a less common type that is usually painless. It is caused by unregulated blood flow to the penis, often due to trauma or an arteriovenous fistula. This type of priapism can typically be managed conservatively.
• Stuttering priapism is characterized by recurrent episodes of ischemic priapism that last less than 4 hours. It is most commonly seen in patients with sickle cell disease and is often self-limited.

The management of ischemic priapism typically involves a combination of local anesthesia, cavernosal aspiration (removal of blood from the corpus cavernosum), and irrigation (flushing the corpus cavernosum with fluid). In some cases, injection with a vasoconstrictor such as phenylephrine may be used to help restore normal blood flow to the penis.

It is important to note that all types of priapism require medical attention, as untreated priapism can cause permanent damage to the penis.