• Emerg Med Pract · Jan 2017

    Review

    Emergency Department Management Of Priapism.

    • Gregory S Podolej and Christine Babcock.
    • Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL.
    • Emerg Med Pract. 2017 Jan 1; 19 (1): 1-16.

    AbstractPriapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. Evidence-based management and appropriate urologic follow-up of nonischemic and recurrent ischemic priapism maximizes patient outcomes and resource utilization.

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