Thursday, January 1, 2015


Everyday EBM
Everyday EBM - December 31, 2014
"Review: Priapism is defined as an undesired erection lasting more than 4 hours, and can be divided into ischemic (low flow), non-ischemic (high flow) and stuttering (i.e. recurrent or intermittent) etiologies. Prolonged ischemic priapism results in erectile dysfunction, corporeal fibrosis, and tissue necrosis. Ischemic priapism results in a fully erect, painful penis; whereas non-ischemic priapism (which is less commonly seen) typically presents with a partially erect penis without persistent pain. Sickle cell disease, thalassemia, leukemia, multiple myeloma, and medication side effects (intracorporeal injections, antidepressants, antihypertensives, and recreational drugs such as cocaine) are all potential risk factors for ischemic priapism; whereas non-ischemic priapism is usually attributable to congenital or traumatic arterio-venous malformations. Stuttering priapism has been less studied but its etiology is thought to be related to ischemic priapism, and is seen more commonly in men with sickle cell disease, or more rarely with neurological disorders. Overall incidence of priapism is low (1.5 per 100,000 person-years in all comers) but much higher in some populations (89% of males with sickle cell anemia will have an episode of priapism by age 20)."