Article Sections

Introduction

Priapism is a condition characterized by prolonged penile erection.  Impaired regulation of penile blood flow causes persistent engorgement of erectile tissue (ie, corpora cavernosa) in the absence of sexual stimulation.  Nonischemic priapism results from unregulated arterial flow into the penis and is often a self-limiting process.  Ischemic priapism occurs due to obstruction of venous outflow from an erect penis and is a urologic emergency.  Prolonged tumescence from ischemic priapism can lead to penile compartment syndrome, tissue hypoxia/necrosis, and permanent erectile dysfunction.  Although most cases are idiopathic, certain medications (eg, trazodone) and medical conditions (eg, sickle cell disease) are important risk factors.

Pathophysiology

In a normal erection, parasympathetic activation induces dilation of the cavernous arteries, increasing blood flow into the corpora cavernosa ( Figure 1

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Figures

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