Priapism

Priapism. Priapism is a therapeutical emergency for 2 major reasons: the risk of cavernous acute ischemia specific to acute venous priapism by far the most frequent, and to avoid the erectile sequels by treating before the 24th hour. The physiopathological diagnosis and the etiological check-up are two mandatory steps for the treatment. In the majority of cases, the clinical step easily differentiates between the arterial or venous (acute or not) type. Major progress, the treatment must be always progressive and adapted to both (arterial and venous) mechanism and anoxic suffering explaining the cavernous blood gas role. In case of venous acute priapism, the medical treatment, always efficient before the 24th hour, has reduced the surgery only indicated for patients consulting too late. The prevention of erectile sequels that too often concern young people requires: a) to sensitize the at-risk populations (sickle cell disease or drug therapy for erectile dysfunction), 2) to homogenize the first line care treatment.