Priapism

Definition: Persistent, painful erection in absence of sexual stimulation.

Causes

  1. Idiopathic
  2. Injection of drugs for impotence
  3. Haematological disease: leukaemia, sickle cell anaemia, paraproteinaemias
  4. Trauma (fistula between pudendal artery and corpora cavernosa)
  5. Malignant infiltration

Clinical features

Only corpora cavernosa affected. Glans is flaccid.

Treatment

Emergency!
  1. Insert two large bore cannulae into corpora cavernosa through glans penis.
  2. Infuse normal saline into one, aspirate from the other
  3. Inject phenylephrine