Emergency: requires immediate attention
Priapism
Alerts and Notices
Synopsis
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.
It is important to note that all types of priapism require medical attention, as untreated priapism can cause permanent damage to the penis.
Codes
ICD10CM:N48.30 – Priapism, unspecified
SNOMEDCT:
6273006 – Priapism
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Ischemic:- Hemoglobinopathy (sickle cell disease, thalassemia [alpha or beta])
- Leukemia
- Infection
- Neurogenic
- Toxin (scorpion, spider)
- Henoch-Schönlein purpura
- Trauma / spinal cord injury
- Hematologic (sickle cell disease, leukemia)
- Fabry disease
- Iatrogenic (surgery)
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:01/04/2023
Last Updated:02/05/2023
Last Updated:02/05/2023