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Review
. 2013 Jan;15(1):20-6.
doi: 10.1038/aja.2012.83. Epub 2012 Dec 3.

A pathophysiology-based approach to the management of early priapism

Jason R Kovac  1 , Siu K Mak, Maurice M Garcia, Tom F Lue
Affiliations
Review

A pathophysiology-based approach to the management of early priapism

Jason R Kovac et al. Asian J Androl. 2013 Jan.

Abstract

Priapism is a rare condition that involves persistent penile erection for greater than 4 h. Distinct variants exist, each with unique characteristics. Ischemic priapism is a painful medical emergency that may occur as a result of veno-occlusion leading to hypoxia and tissue death. Recurrent bouts of ischemic priapism, or stuttering priapism, require treatment for individual attacks as well as long-term prevention. Non-ischemic priapism is associated with trauma and may be managed conservatively. Recent advances into the pathophysiology of priapism have allowed the development of treatment algorithms that specifically target the mechanisms involved. In this review, we outline the basics of smooth muscle contraction and describe how derangement of these pathways results in priapism. A pathophysiological approach to the treatment of priapism is proposed with duration-based algorithms presented to assist in management.

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Figures

Figure 1
Figure 1
Pathophysiology and duration based algorithm for the treatment of ischemic priapism. A supplementary video of the T-Shunt and Tunnelling procedure can be accessed at the Asian Journal of Andrology′s website (http://www.nature.com/aja). PE, physical exam.
Figure 2
Figure 2
Pathophysiological algorithm for the treatment of non-ischemic priapism. PE, physical exam.
See this image and copyright information in PMC

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