Treating stuttering priapism.

Stuttering priapism is an uncommon recurrent form of ischaemic priapism consisting of episodes of unwanted, painful erections that typically last for <3 h. It occurs repeatedly with intervening periods of detumescence. If these episodes are not treated, it may evolve into a classic ischaemic priapism and eventually lead to irreversible corporal fibrosis with permanent erectile dysfunction. A comprehensive literature search was conducted in August 2010 using the PubMed database, MEDLINE and generic search engines. The search terms used to source information on this topic were, stuttering priapism (44 hits) and recurrent priapism (161 hits). Although there are numerous publications on this topic the majority of them are small trials and case reports. We identified 117 case reports, 28 reviews, 37 anecdotal reports, 22 small size clinical trials and one in vitro work. Our understanding of the underlying pathophysiology of stuttering priapism has improved in recent years. Further multicentre randomized clinical trials are required to evaluate the efficacy of different treatment options and to define safe and effective management strategies for patients with low-flow recurrent priapism.