Clinical meaning
Priapism is a prolonged, persistent penile erection lasting more than 4 hours that is unrelated to sexual stimulation or desire. It occurs when blood becomes trapped in the erectile tissue (corpora cavernosa) of the penis and cannot drain properly. The most common type is ischemic (low-flow) priapism, where venous outflow is blocked, trapping deoxygenated blood in the corpora cavernosa. Without blood flow, the tissue becomes ischemic (oxygen-deprived), and if untreated beyond 4-6 hours, permanent damage to the erectile tissue can occur, leading to fibrosis and erectile dysfunction. Priapism is a MEDICAL EMERGENCY. Common causes include sickle cell disease (the most common cause in children), medications such as PDE5 inhibitors (sildenafil), intracavernosal injections, antipsychotics, and blood disorders.
Exam relevance
Risk factors: - Sickle cell disease (most common cause in children and adolescents) - Use of PDE5 inhibitors (sildenafil, tadalafil) - Intracavernosal injection therapy for erectile dysfunction - Antipsychotic medications (trazodone, chlorpromazine) - Blood disorders (leukemia, polycythemia) - Cocaine or marijuana use - Spinal cord injury - Pelvic trauma