Priapism Flashcards
(34 cards)
What is priapism?
A pathological condition representing a true disorder of penile erection that persists for more than 4 hours and is unrelated to sexual interest or stimulation.
At what ages can priapism occur?
At all ages.
What is the incidence rate of priapism in the general population?
0.5-0.9 cases per 100,000 person-years.
What is the prevalence of priapism in patients with sickle cell disease (SCD) under 18 years of age?
Up to 3.6%.
What is the prevalence of priapism in patients with SCD aged 18 years or older?
Up to 42%.
What are the two main types of priapism?
Ischaemic (low-flow) and non-ischaemic (high-flow).
Which type of priapism is more common?
Ischaemic priapism (>95% of cases).
What characterizes ischaemic priapism?
Painful, rigid erection with absent or reduced intracavernous arterial inflow.
How is prolonged ischaemic priapism (>4h) classified?
As a compartment syndrome.
What is necessary for ischaemic priapism management?
Emergency medical intervention to minimize irreversible consequences.
What are potential irreversible consequences of untreated ischaemic priapism?
Corporal fibrosis and permanent erectile dysfunction (ED).
Name risk factors for ischaemic priapism.
Sickle cell disease, neoplastic syndromes, metastatic infiltration, and medications.
Which medications can induce ischaemic priapism?
Intracavernous erectogenic agents (especially papaverine-based combinations), PDE5 inhibitors (rarely).
What histological changes occur at 12 hours of priapism?
Interstitial oedema, sinusoidal endothelium destruction, and thrombocyte adherence.
What changes are seen at 24 hours of priapism?
Exposure of the basement membrane and thrombocyte adherence.
What happens after 48 hours of priapism?
Thrombi in sinusoidal spaces and evident fibrosis.
What is the most significant predictor of ED in priapism?
The duration of priapism.
Is intervention after 48-72 hours helpful?
It may relieve erection and pain but has little benefit in preventing ED.
What is the most frequent cause of high-flow priapism?
Blunt perineal or penile trauma.
What injury results in high-flow priapism?
Laceration in the cavernosal artery leading to a high-flow fistula.
How long after injury can high-flow priapism develop?
There may be a delay of 2-3 weeks.
How does high-flow priapism present?
Erection that is not fully rigid and not associated with pain.
How is blood aspiration used in diagnosis?
Bright red arterial blood suggests non-ischaemic; dark blood suggests ischaemic priapism.
What is seen on blood gas analysis in ischaemic priapism?
Low oxygen, high CO2, and acidic pH.
