The treatment of priapism--when and how?

Priapism is a condition first described by Tripe in 1845. It has been defined as a pathological condition of penile erection that persists beyond or is unrelated to sexual stimulation. Two variants of priapism have been well described. The ischemic priapism (also known as low-flow priapism) and nonischemic priapism (or high flow priapism) have unique and distinct causes. It is important to distinguish these two conditions as the treatment for each is different. This review will focus on the two types of priapism and the appropriate diagnostic work-up for each. As well, the medical and surgical treatment options for these two conditions will be described in detail. A third entity known as stuttering priapism will also be discussed as will its unique treatment alternatives.