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Priapism

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  1. Definitions
    1. Prolonged Erection lasts longer than 4 hours
    2. Priapism lasts longer than 6 hours
  2. Causes
    1. Ascending nerve impulses from urethral lesion
    2. Descending nerve impulses from cerebral lesion
    3. Direct stimulation
      1. Spinal cord lesion
      2. Nervi erigentes
    4. Local injury
      1. Thrombosis
      2. Hemorrhage
      3. Neoplasm
      4. Inflammation
    5. Iatrogenic
      1. Intracorporal Alprostadil (Caverject)
    6. Systemic Disease
      1. Leukemia
      2. Sickle Cell Anemia
        1. See Priapism in Sickle Cell Anemia
  3. Symptoms
    1. Prolonged, persistant penile Erection
    2. Ocurs without sexual desire
    3. Often painful
  4. Management: Priapism following Alprostadil
    1. Patient contacts office for Erection over 3 hours
    2. Attempt aspiration of corpora
      1. Volume: 10 to 20 ml blood
      2. Needle: 19 gauge butterfly needle
    3. Phenylephrine 1% (10 mg/ml) 1 ml in 9 ml NS
      1. Inject 0.5 ml (0.5 mg Phenylephrine)
      2. Administer intracorporal every 10 minutes
      3. Repeat Phenylephrine until detumescence
      4. Monitor Blood Pressure and Pulse every 15 min
      5. Monitor for minimum of one hour
    4. Consider Urology consultation

Priapism (C0033117)

Definition (MSH)A prolonged painful erection that may lasts hours and is not associated with sexual activity. It is seen in patients with SICKLE CELL ANEMIA, advanced malignancy, spinal trauma; and certain drug treatments.
ConceptsDisease or Syndrome (T047)
ICD9607.3
MSHD011317
EnglishCHRONIC ERECTION, Mentulagra, Pathologic erection, Priapism, Priapisms
Spanishereccion patologica, priapismo
Parent ConceptsPenile Diseases (C0030846), Sexual Dysfunction (C0549622), Autonomic nervous system disorders (C1145628), Penile vascular disorder NOS (C0156307), Duplicate concept (C1274013)
SourcesCOSTAR, CST, DXP, ICD9CM, LCH, MSH, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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