Presentation and Surgical Management of Ischemic Priapism: A 5-Year Review

Terkaa Atim*, Oseremen Inokhoife Aisuodionoe-Shadrach and Ajibola OH

Presentation and Surgical Management of Ischemic Priapism: A 5-Year Review

Priapism is a persistent, usually painful, erection that lasts for more than four hours, occurs
without sexual stimulation and is unrelieved by ejaculation. It was first described in 1845 by
Tripe,1 as it is a relatively uncommon occurrence and as a result, there is scant contemporary
literature on standardized treatment of males who experienced priapism.

Two types of priapism, namely the ischemic priapism (also known as low-flow priapism)
and non-ischemic priapism
(or high flow priapism) have been well described.

They both have specific and different causes and their management also vary from each other.
The causative mechanisms even though not
clearly understood, involve complex neurovascular factors.

It may be associated with the use of intracavernous injections for erectile dysfunction, sickle cell disease (SCD), recreational drugs (cocaine and marijuana abuse), antipsychotic therapy, blood cancers like leukemia and
perineal trauma.2,3 Adeyoju et al6 reported a high incidence (35%) of priapism among patients
with sickle cell anemia which they identified as a common aetiological factor.

Badmus in an earlier study, also noted SCD as the commonest cause of priapism
in southwestern Nigeria, whereas Aghaji2 in his series reported local aphrodisiac as the
commonest predisposing factor of priapism in Eastern Nigeria followed by SCD.

Whereas, use of intracavernous therapy is a common aetiological factor in the advanced countries, it
is certainly rare in the poor resource settings like ours due to cost constraint and scarcity.2
Although, not all patients require immediate elaborate treatment, it is imperative to differentiate.

Urol Androl Open J. 2017; 1(2): 22-25. doi: 10.17140/UAOJ-1-106