Management of priapism: An update for clinicians

Helen R. Levey, Robert L. Segal, Trinity J. Bivalacqua

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Priapism is a prolonged erection that persists beyond or is unrelated to sexual stimulation. It is associated with significant morbidity: psychological, socioeconomic, and physical, including pain and potentially irreversible compromise of erectile function. There are three major types of priapism: ischemic, nonischemic, and stuttering. Establishing the type of priapism is paramount to safely and effectively treating these episodes. Ischemic priapism represents a urological emergency. Its treatment may involve aspiration/irrigation with sympathomimetic injections, surgical shunts, and as a last resort, penile prosthesis implantation. Nonischemic priapism results from continuous flow of arterial blood into the penis, most commonly related to penile trauma. This is not an emergency and may be managed conservatively initially, as most of these episodes are self-limiting. Stuttering priapism involves recurrent self-limiting episodes of ischemic priapism. The primary goal of therapy is prevention, but acute episodes should be managed in accordance with guidelines for ischemic priapism. In this paper we review the diagnosis and treatment of the three priapism variants, as well as discuss future targets of therapy and novel targets on the horizon.

Original languageEnglish (US)
Pages (from-to)230-244
Number of pages15
JournalTherapeutic Advances in Urology
Issue number6
StatePublished - Dec 2014


  • guidelines
  • ischemic
  • non-ischemic
  • priapism
  • recurrent
  • stuttering

ASJC Scopus subject areas

  • Urology


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