title: Acute management of priapism in men.
abstract: What's known on the subject? and What does the study add? Priapism is a rare event. However, various medications and medical conditions may increase the risk. Priapism can be ischaemic, non-ischaemic or stuttering. It is paramount to distinguish the type of priapism, as misdiagnosis may lead to significant morbidity. Ischaemic priapism represents a compartment syndrome of the penis and is therefore a medical emergency. A delay in management may significantly affect future erectile function. Stuttering priapism represents recurrent subacute episodes of ischaemic priapism, which may lead to erectile dysfunction. Thus episodes must be minimised. Non-ischaemic priapism is not a medical emergency. However, misdiagnosis and injection with sympathomimetic agents can result in system absorption and toxicity. This review article provides a summary of the evaluation and management of priapism. Furthermore, a step by step flow chart is provided to guide the clinician through the assessment and management of this complex issue.
  
  
  OBJECTIVE
  To review the literature regarding ischaemic, non-ischaemic and stuttering priapism. To provide management recommendations.
  
  
  METHODS
  A Medline search was carried out to identify all relevant papers with management guidelines for priapism.
  
  
  RESULTS
  Ischaemic priapism represents a compartment syndrome of the penis and urgent intervention is required to decrease the risk of erectile dysfunction. Non-ischaemic priapism is not a medical emergency; however, it can result in erectile dysfunction. The treatment objective for stuttering priapism is to reduce future episodes with systemic treatments, whilst treating each ischaemic episode as an emergency.
  
  
  CONCLUSIONS
  Priapism is a complex condition that requires expert care to prevent complications and irreversible erectile dysfunction.
authors.affiliation: Department of Urology, Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Yeng K
authors.initials: YK
authors.lastname: Tay
authors.forename: Daniel
authors.initials: D
authors.lastname: Spernat
authors.forename: Kathryn
authors.initials: K
authors.lastname: Rzetelski-West
authors.forename: Sree
authors.initials: S
authors.lastname: Appu
authors.forename: Chris
authors.initials: C
authors.lastname: Love
mesh_terms: D019468:Disease Management; D006801:Humans; D007267:Injections; D008297:Male; D026741:Physical Therapy Modalities; D011317:Priapism / Q000175:diagnosis / Q000628:therapy*; D013566:Sympathomimetics / Q000008:administration & dosage*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
chemical_list: D013566:Sympathomimetics