Priapism

* Is a true urologic emergency
* Is a persistent, painful erection in which both the corpora cavernosa are engorged with blood
* Most common in ages 2-5 and 20-50
* There are two types of priapism: High flow and Low flow
* High flow- rare and related to increased arterial flow, most often in the setting of trauma. This is often not painful or less painful and may present with only a semi-rigid penis (less emergent)
* Low flow- more common and related to ischemia, affecting the venous system. Long term damage can occur with cell/tissue damage after 24 hours.
* For low flow: the most common medications implicated are trazadone and chlorpromazine but the erectile dysfunction medications and some HTN medications such as calcium channel blockers and hydralazine have been implicated as well. Other etiologies are tumor burden (GU tumors) as well as sickle cell disease (the most common cause in children)

ref: Rosen's