Priapism - Revision history

Danbot: Strip excess bold

2026-03-22T09:37:01Z

Strip excess bold

← Older revision		Revision as of 09:37, 22 March 2026
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	====α/β-2 Agonist====		====α/β-2 Agonist====
	#Consider [[terbutaline]]<ref>Lowe FC, Jarow JP. Placebo-controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin E1-induced prolonged erections. Urology. Jul 1993;42(1):51-3</ref>		#Consider [[terbutaline]]<ref>Lowe FC, Jarow JP. Placebo-controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin E1-induced prolonged erections. Urology. Jul 1993;42(1):51-3</ref>
	#*Dose: 0.25-0.5mg SQ in deltoids ~~'''~~OR~~'''~~ 5-10mg PO, may repeat in q20min		#*Dose: 0.25-0.5mg SQ in deltoids OR 5-10mg PO, may repeat in q20min
	#[[Phenylephrine]]		#[[Phenylephrine]]
	#*Dilute phenylephrine 1ml of 1mg/ml in 9mL NS for final concentration of 100mcg/mL		#*Dilute phenylephrine 1ml of 1mg/ml in 9mL NS for final concentration of 100mcg/mL
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	*Supplemental [[oxygen]]		*Supplemental [[oxygen]]
	*[[pRBCs\|Transfusion]] for goal HCT>30% with consultation for partial exchange transfusion (HGB-S<30%)		*[[pRBCs\|Transfusion]] for goal HCT>30% with consultation for partial exchange transfusion (HGB-S<30%)
	**[[Exchange transfusion]] is associated with ~~'''~~ASPEN syndrome~~'''~~ (~~'''A'''ssociation~~ of ~~'''S'''ickle~~ cell ~~'''P'''riapism~~, ~~'''E'''xchange~~ transfusion & ~~'''N'''eurological~~ events)		**[[Exchange transfusion]] is associated with ASPEN syndrome (Association of Sickle cell Priapism, Exchange transfusion & Neurological events)
	*Urology consult		*Urology consult

Danbot: Add MedicationDose SMW entries for phenylephrine and terbutaline; doses verified against AUA guidelines

2026-03-20T17:57:17Z

Add MedicationDose SMW entries for phenylephrine and terbutaline; doses verified against AUA guidelines

← Older revision		Revision as of 17:57, 20 March 2026
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	[[Category:Urology]]		[[Category:Urology]]
	[[Category:Procedures]]		[[Category:Procedures]
			==Medication Dosing==
			*{{MedicationDose\|drug=Phenylephrine\|dose=100-200 mcg intracavernosal q3-5min\|route=Intracavernosal\|context=Alpha-agonist for ischemic priapism\|indication=Priapism\|population=Adult\|max_dose=1000 mcg\|notes=Dilute to 100 mcg/mL; monitor BP/HR}}
			*{{MedicationDose\|drug=Terbutaline\|dose=0.25-0.5 mg SQ or 5-10 mg PO\|route=SQ/PO\|context=Beta-agonist (adjunct)\|indication=Priapism\|population=Adult\|notes=May repeat q20min}}

			]

Rossdonaldson1: /* Video */

2024-04-17T20:11:10Z

Video

← Older revision		Revision as of 20:11, 17 April 2024
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	*Admit if refractory to treatment or need or IR or surgical intervention		*Admit if refractory to treatment or need or IR or surgical intervention
	*May discharge home if treatment is successful with close follow-up by urology		*May discharge home if treatment is successful with close follow-up by urology

	~~==Video==~~
	~~{{#widget:YouTube\|id=73c8-GwE6tY}}~~

	==References==		==References==

Kfarzam: /* Management */

2022-08-20T05:50:38Z

Management

← Older revision		Revision as of 05:50, 20 August 2022
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	[[File:PMC4719504 UA-8-118-g001.png\|thumb\|(a) Penis rigid and firm in consistency on examination (b) Aspiration from cavernosa using 16G needle showed deoxygenated blood with detumescence.]]		[[File:PMC4719504 UA-8-118-g001.png\|thumb\|(a) Penis rigid and firm in consistency on examination (b) Aspiration from cavernosa using 16G needle showed deoxygenated blood with detumescence.]]
	*[[analgesia\|Pain control]]: [[Morphine]] and/or [[penile nerve block]]		*[[analgesia\|Pain control]]: [[Morphine]] and/or [[penile nerve block]]
	*Running in place or doing squats can potentially achieve detumescence<ref>Gravel J, Leblanc C, Varner C. Management of priapism with a trial of exercise in the emergency department. CJEM. 2019;21(1):150-153.</ref>		*Running in place or doing squats (or some form of intensive exercise) can potentially achieve detumescence<ref>Gravel J, Leblanc C, Varner C. Management of priapism with a trial of exercise in the emergency department. CJEM. 2019;21(1):150-153.</ref>

	===Low Flow Priapism===		===Low Flow Priapism===

Elcatracho: /* High-flow (nonischemic) */

2021-02-12T16:37:59Z

High-flow (nonischemic)

← Older revision		Revision as of 16:37, 12 February 2021
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	====High-flow (nonischemic)====		====High-flow (nonischemic)====
	*Rare		*Rare
			*Associated with trauma or instrumentation
	*Usually painless		*Usually painless
	*Increased arterial flow		*Increased arterial flow

Kxl328: /* Management */

2020-07-30T18:53:35Z

Management

← Older revision		Revision as of 18:53, 30 July 2020
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	[[File:PMC4719504 UA-8-118-g001.png\|thumb\|(a) Penis rigid and firm in consistency on examination (b) Aspiration from cavernosa using 16G needle showed deoxygenated blood with detumescence.]]		[[File:PMC4719504 UA-8-118-g001.png\|thumb\|(a) Penis rigid and firm in consistency on examination (b) Aspiration from cavernosa using 16G needle showed deoxygenated blood with detumescence.]]
	*[[analgesia\|Pain control]]: [[Morphine]] and/or [[penile nerve block]]		*[[analgesia\|Pain control]]: [[Morphine]] and/or [[penile nerve block]]
			*Running in place or doing squats can potentially achieve detumescence<ref>Gravel J, Leblanc C, Varner C. Management of priapism with a trial of exercise in the emergency department. CJEM. 2019;21(1):150-153.</ref>

	===Low Flow Priapism===		===Low Flow Priapism===

Rossdonaldson1: /* Management */

2020-07-18T13:05:01Z

Management

← Older revision		Revision as of 13:05, 18 July 2020
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	==Management==		==Management==
			[[File:PMC4719504 UA-8-118-g001.png\|thumb\|(a) Penis rigid and firm in consistency on examination (b) Aspiration from cavernosa using 16G needle showed deoxygenated blood with detumescence.]]
	*[[analgesia\|Pain control]]: [[Morphine]] and/or [[penile nerve block]]		*[[analgesia\|Pain control]]: [[Morphine]] and/or [[penile nerve block]]

Spenceemmett: /* Management */

2020-07-15T16:03:25Z

Management

← Older revision		Revision as of 16:03, 15 July 2020
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	#*In pediatric population, intracavernosal injection of epinephrine instead of phenylephrine has been shown more successful in achieving detumescence		#*In pediatric population, intracavernosal injection of epinephrine instead of phenylephrine has been shown more successful in achieving detumescence
	''Wrap penis in elastic bandage after detumescence is achieved''		''Wrap penis in elastic bandage after detumescence is achieved''

			===Refractory===
			*Emergent urology consult for possible shunt procedure (can often be done in ED)

	===High Flow Priapism===		===High Flow Priapism===

Spenceemmett: /* Causes */

2020-07-15T15:43:15Z

Causes

← Older revision		Revision as of 15:43, 15 July 2020
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	***[[SSRIs]]/[[trazodone]]		***[[SSRIs]]/[[trazodone]]
	***[[Antipsychotics]]		***[[Antipsychotics]]
	***Erectile dysfunction medications (e.g. [[sildenafil)		***Erectile dysfunction medications (e.g. [[sildenafil]])
	**Drugs of abuse		**Drugs of abuse
	***[[Cocaine]] use<ref>reen J, Hakim L. Cocaine-induced veno-occlusive priapism: importance of		***[[Cocaine]] use<ref>reen J, Hakim L. Cocaine-induced veno-occlusive priapism: importance of

SuperD: /* α/β-2 Agonist */

2020-02-10T11:59:26Z

α/β-2 Agonist

← Older revision		Revision as of 11:59, 10 February 2020
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	#*Dose: 0.25-0.5mg SQ in deltoids '''OR''' 5-10mg PO, may repeat in q20min		#*Dose: 0.25-0.5mg SQ in deltoids '''OR''' 5-10mg PO, may repeat in q20min
	#[[Phenylephrine]]		#[[Phenylephrine]]
	#*Dilute phenylephrine 1mg in 9mL NS for final concentration of 100mcg/mL		#*Dilute phenylephrine 1ml of 1mg/ml in 9mL NS for final concentration of 100mcg/mL
	#**For 500 mcg/ml, take 0.5 ml of 10mg/ml phenylephrine, and dilute in 9.5 cc NS		#**For 500 mcg/ml, take 0.5 ml of 10mg/ml phenylephrine, and dilute in 9.5 cc NS
	#*Inject base of penis with 29-Ga needle (after blood aspiration to confirm position)		#*Inject base of penis with 19-Ga needle (after blood aspiration to confirm position)
	#**100-~~500~~ mcg every 3-5min (max 1000 mcg) until resolution or 1 hour		#**100-200 mcg every 3-5min (max 1000 mcg) until resolution or 1 hour
	#*Ensure patient fully monitored, with BP, HR, pulse oximetry		#*Ensure patient fully monitored, with BP, HR, pulse oximetry
	#**Reflex bradycardia is expected, so consider dosages relative to toleration of drop from baseline HR		#**Reflex bradycardia is expected, so consider dosages relative to toleration of drop from baseline HR