Update on the pathophysiology, diagnosis and treatment of priapism

• Published in: Universidad Médica Pinareña Vol. 18; no. 1; p. e608
• Main Authors: Elia de la Caridad Rodríguez-Venegas, Daniel Alejandro Denis-Piedra, Omar Luis Hernández-García
• Format: Journal Article
• Language: English
• Published: Universidad de Ciencias Médicas de Pinar del Río 01.11.2020
• Subjects: enfermedades de los genitales masculinos; enfermedades del pene; enfermedades urogenitales masculinas; priapismo
• ISSN: 1990-7990

Introduction: priapism is defined as a prolonged and persistent erection of the penis that is unrelated to sexual desire; it can last more than 4 hours and constitutes a medical emergency. The incidence recorded in the general population is 1,5 cases per 100,000 persons per year and in those over 40 years of age it reaches 2,9. Objective: to describe the pathophysiology, diagnosis and treatment of priapism. Method: a search for information was carried out in English and Spanish, consulting the Pubmed, SciELO, Lilacs, Cochrane Library and Web of Science databases. Twenty-four articles were chosen for the development of this review. Development: there are two pathophysiological variants of priapism, ischemic or low-flow priapism, which causes pain and is an emergency, which can lead to permanent erectile dysfunction, and non-ischemic or high-flow priapism. Diagnosis is mainly clinical, although tests that evaluate blood flow, such as Doppler ultrasound, are useful. Therapeutic management will depend on the cause of priapism and the time elapsed since the onset of the condition. Conclusions: priapism is a rare disease, with different forms of presentation depending on the etiology; where this determines the symptoms, evolution and damage to the male reproductive organ. Diagnosis is mainly clinical, although techniques such as Doppler ultrasound are useful. Therapeutic alternatives vary from primary administration of anti-androgens to surgical alternatives such as shunts and cavernostomy.