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A narrative review of initial treatment for ischemic priapism

International Journal of Impotence Research (2024)Cite this article

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Abstract

Priapism is a rare condition characterized by prolonged and often painful penile erection unrelated to sexual stimulation. Ischemic priapism, the most common subtype, requires immediate attention to prevent irreversible damage to erectile tissue. This narrative review explores the initial management strategies for ischemic priapism. Intracavernosal phenylephrine injection and aspiration with or without irrigation are recommended as first-line treatments, with alternative options available depending on clinical settings and patient factors. While guidelines offer clear recommendations for priapism lasting more than 4 h, management of shorter-duration cases remains challenging due to limited evidence.

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Fig. 1: Diagram of the initial management of patient presenting with priapism.

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Authors and Affiliations

  1. Department of Urology, University of California, Irvine, CA, USA

    Supanut Lumbiganon, Muhammed A. Moukhtar Hammad, Babak Azad & Faysal A. Yafi

  2. Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Supanut Lumbiganon

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  1. Supanut Lumbiganon
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The authors confirm responsibility for the following: study conception and design SL, MH, BA, FY; manuscript drafting SL; manuscript revision and finalization SL, MH, BA, FY. Supanut Lumbiganon, SL. Muhammed A Moukhtar Hammad, MH. Babak Azad, BA. Faysal A Yafi, FY.

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Correspondence to Faysal A. Yafi.

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Lumbiganon, S., Moukhtar Hammad, M.A., Azad, B. et al. A narrative review of initial treatment for ischemic priapism. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00951-1

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