title: European Association of Urology guidelines on priapism.
abstract: BACKGROUND
  Priapism is defined as a penile erection that persists beyond or is unrelated to sexual interest or stimulation. It can be classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent or intermittent).
  
  
  OBJECTIVE
  To provide guidelines on the diagnosis and treatment of priapism.
  
  
  METHODS
  Systematic literature search on the epidemiology, diagnosis, and treatment of priapism. Articles with highest evidence available were selected to form the basis of these recommendations.
  
  
  RESULTS
  Ischaemic priapism is usually idiopathic and the most common form. Arterial priapism usually occurs after blunt perineal trauma. History is the mainstay of diagnosis and helps determine the pathogenesis. Laboratory testing is used to support clinical findings. Ischaemic priapism is an emergency condition. Intervention should start within 4-6h, including decompression of the corpora cavernosa by aspiration and intracavernous injection of sympathomimetic drugs (e.g. phenylephrine). Surgical treatment is recommended for failed conservative management, although the best procedure is unclear. Immediate implantation of a prosthesis should be considered for long-lasting priapism. Arterial priapism is not an emergency. Selective embolization is the suggested treatment modality and has high success rates. Stuttering priapism is poorly understood and the main therapeutic goal is the prevention of future episodes. This may be achieved pharmacologically, but data on efficacy are limited.
  
  
  CONCLUSIONS
  These guidelines summarise current information on priapism. The extended version are available on the European Association of Urology Website (www.uroweb.org/guidelines/).
  
  
  RESULTS
  Priapism is a persistent, often painful, penile erection lasting more than 4h unrelated to sexual stimulation. It is more common in patients with sickle cell disease. This article represents the shortened EAU priapism guidelines, based on a systematic literature review. Cases of priapism are classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent). Treatment for ischaemic priapism must be prompt in order to avoid the risk of permanent erectile dysfunction. This is not the case for arterial priapism.
authors: Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.
authors: Andrea
authors: A
authors: Salonia
authors: Department of Urology, St. James University Hospital, Leeds, UK.
authors: Ian
authors: I
authors: Eardley
authors: Versailles Saint Quentin en Yvelines University, Garches, France, Neurology-Urology-Andrology, Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Garches, France.
authors: François
authors: F
authors: Giuliano
authors: Aristotle University of Thessaloniki, Centre for Sexual and Reproductive Health and 2nd Department of Urology, Thessaloniki, Greece.
authors: Dimitrios
authors: D
authors: Hatzichristou
authors: Department of Urology, Hospital Sanitas La Zarzuela, Madrid, Spain.
authors: Ignacio
authors: I
authors: Moncada
authors: Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel.
authors: Yoram
authors: Y
authors: Vardi
authors: Department of Urology, CHU de Charleroi, Hôpital Erasme, Brussels, Belgium.
authors: Eric
authors: E
authors: Wespes
authors: 2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: promahon@otenet.gr.
authors: Konstantinos
authors: K
authors: Hatzimouratidis
mesh_terms: D006801:Humans; D008297:Male; D010410:Penile Erection; D011317:Priapism / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D013566:Sympathomimetics / Q000627:therapeutic use*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000592:standards*; D014572:Urology / Q000592:standards*
chemical_list: D013566:Sympathomimetics
keywords: Arterial; Diagnosis; EAU guidelines; Ischaemic; Medical treatment; Priapism; Stuttering; Treatment