ABSTRACT
Priapism is a prolonged painful penile erection in the absence of sexual stimulation. There are two main types: low flow (the majority) and high flow. Low-flow priapism is a UROLOGICAL EMERGENCY and if left untreated can cause ischaemic necrosis of the penile tissues resulting in erectile dysfunction (ED) or significant shortening. Lowflow priapism is most commonly caused, nowadays, by the pharmacotherapeutic treatment of ED, especially intracavernosal injection therapy, but any ED therapy can cause it. Other causes include sickle cell disease and leukaemia; some cases are idiopathic. High-flow priapism is usually the result of trauma to the perineum (which may be minor) often several days before. The injury results in an abnormal arterialsinusoidal shunt that causes engorgement of the penis. Table 1 is useful to distinguish between the two types of priapism described.
