1 | INTRODUCTION
Priapism is defined as complete or
partial penile tumescence that
continues for 4 or more hours beyond
or without sexual stimulation. In the
majority of the cases, only corpora
cavernosa is affected without
involvement of corpus spongiosum
and glans. Most cases of priapism are
idiopathic, with 21% of the cases
were associated with alcohol or drug
abuse, 12% were associated with
perineal trauma, and 11% were
associated with sickle cell disease.
Iatrogenic causes of priapism were
more prevalent in the mid-1980s due
to the availability of intracavernous
self-injected drugs such as
phentolamine, prostaglandin, and
papaverine.1
Priapism is classified into three types:
Ischemic (veno-occlusive or low-
flow) priapism, stuttering priapism,
and nonischemic (arterial, high-flow)
priapism.2 Ischemic priapism is
characterized with persistent erection
with rigidity of the corpora cavernosa
and little to no cavernous arterial
inflow. Ischemic priapism is an
emergency condition that requires
prompt treatment in order to prevent
erectile dysfunction. Stuttering
priapism is characterized with a
pattern of recurrence, most
prevalently found in men with sickle-
cell disease (SCD). Nonischemic
priapism is a persistent erection
caused by unregulated cavernous
arterial inflow, characterized with
tumescent corpora without rigidity
and pain. The pathogenetic
mechanism of nonischemic priapism
is a creation of arteriolar-sinusoidal
fistula due to disruption of cavernous
arterial anatomy.1, 2
The majority of cases in priapism
were ischemic priapism, accounting
more than 95% of all priapism cases.
The priapic episode often precipitated
with previous sexual stimulation with
or without usage of drugs. Sickle-cell
disease is one of the risk factors for
occurrence of priapism, with
prevalence ranging from 29 – 42%,
most commonly found in children and
adolescents. The suggested
prevalence from a literature were 2 –
6% with the majority of the cases
were ischemic due to SCD.3 While
newborns may suffer from priapism,
such occurrence may be extremely
rare, therefore limiting the diagnostic
and management recommendation
and modalities..2