penis maintains a prolonged erection (>4 hours) in the absence of appropriate stimulation.
is compartment syndrome of the penis.
Ischemia and infarction can occur with prolonged priapism and rapid treatment and detumescence is critical
Do not delay aspiration and irrigation if more conservative measures fail as complications (fibrosis, impotence) can occur
The commonest causes of priapism in children are sickle cell disease (65%), leukaemia (10%) and trauma (10%)
types:
Ischemic – low flow
Decreased venous outflow results in increased cavernosal pressure
When cavernosal pressure exceeds arterial pressure, ischemia develops
More common than high-flow version
Typically accompanied by significant pain due to ischemia (can be considered to be compartment syndrome of the penis)
Nonischemic – high flow
Excess arterial inflow resulting in priapism
Often painless
Common causes – Arterial laceration, Spinal trauma
ischemic causes of priapism are a true emergency and require prompt intervention to prevent damage to the penis, which can progress to erectile dysfunction and permanent impotence.
