• Yeng K Tay, Daniel Spernat, Kathryn Rzetelski-West, Sree Appu, and Chris Love.
• Department of Urology, Monash Medical Centre, Melbourne, Victoria, Australia.
• BJU Int. 2012 Apr 1; 109 Suppl 3: 15-21.

UnlabelledWhat's known on the subject? and What does the study add? Priapism is a rare event. However, various medications and medical conditions may increase the risk. Priapism can be ischaemic, non-ischaemic or stuttering. It is paramount to distinguish the type of priapism, as misdiagnosis may lead to significant morbidity. Ischaemic priapism represents a compartment syndrome of the penis and is therefore a medical emergency. A delay in management may significantly affect future erectile function. Stuttering priapism represents recurrent subacute episodes of ischaemic priapism, which may lead to erectile dysfunction. Thus episodes must be minimised. Non-ischaemic priapism is not a medical emergency. However, misdiagnosis and injection with sympathomimetic agents can result in system absorption and toxicity. This review article provides a summary of the evaluation and management of priapism. Furthermore, a step by step flow chart is provided to guide the clinician through the assessment and management of this complex issue.ObjectivesTo review the literature regarding ischaemic, non-ischaemic and stuttering priapism. To provide management recommendations.Patients And MethodsA Medline search was carried out to identify all relevant papers with management guidelines for priapism.ResultsIschaemic priapism represents a compartment syndrome of the penis and urgent intervention is required to decrease the risk of erectile dysfunction. Non-ischaemic priapism is not a medical emergency; however, it can result in erectile dysfunction. The treatment objective for stuttering priapism is to reduce future episodes with systemic treatments, whilst treating each ischaemic episode as an emergency.ConclusionsPriapism is a complex condition that requires expert care to prevent complications and irreversible erectile dysfunction.© 2012 THE AUTHOR. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

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