Editing Priapism (section)

=== Imaging ===

==== Color Doppler US ====
* '''<span style="color:#ff0000">Indications</span>'''
**'''<span style="color:#ff0000">Should not be incorporated into the acute evaluation and management of priapism in the emergency department by non-urologist specialists</span>[https://pubmed.ncbi.nlm.nih.gov/35536142/ ★]'''
***Not the primary way to diagnose priapism
**'''<span style="color:#ff0000">May be utilized in less clearly delineated cases to differentiate between acute ischemic priapism and non-ischemic priapism</span>[https://pubmed.ncbi.nlm.nih.gov/35536142/ ★]'''
*Findings[https://pubmed.ncbi.nlm.nih.gov/34495686/ §]
**Acute ischemic priapism
***Bilateral absence of flow through the cavernosal arteries
***Peak systolic flows <50 cm/sec
***Mean velocity <6.5 cm/sec
***Diastolic reversal (i.e., negative end diastolic velocities)
**Non-ischemic priapism
***Peak systolic velocities of >50 cm/sec.
***In the non-acute setting, may identify anatomical abnormalities, such as a cavernous artery fistula or pseudoaneurysm in patients who already have been diagnosed with non-ischemic priapism. 
****These abnormalities may occur following a straddle injury or direct scrotal trauma and are, therefore, most often found in the perineal portions of the corpora cavernosa.
*Use is limited by
**Number of specialists who can currently perform the procedure
**Equipment might not be readily available
==== Pelvic MRI ====
* Likely does not have a role in the initial diagnostic and treatment phase of priapism'''<span style="color:#ff0000">[https://pubmed.ncbi.nlm.nih.gov/35536142/ ★]</span>'''
*'''Can be used to demonstrate:'''
*# '''A well-established arteriolar-sinusoidal fistula'''
*# '''Presence and extent of tissue thrombus'''
*# '''Corporal smooth muscle infarction'''
*# '''Corporal malignancy or metastasis'''

==== Penile arteriography ====
* Too invasive as a diagnostic procedure to differentiate ischemic from non-ischemic priapism