Editing Priapism (section)

=== Ischemic priapism (veno-occlusive, low-flow) ===
* '''<span style="color:#ff0000">Majority of cases</span>'''
* '''Characterized by little or no cavernous blood flow'''
*'''<span style="color:#ff0000">Associated with</span>''' (features that distinguish this from non-ischemic priapism)
*# '''<span style="color:#ff0000">Pain</span>'''
*# '''<span style="color:#ff0000">Fully rigid and tender corpora cavernosa</span>'''
*# '''<span style="color:#ff0000">Abnormal blood gas</span> (i.e., hypoxic, hypercarbic, acidotic)'''
*#'''<span style="color:#ff0000">Requires prompt evaluation and may require emergency management</span>'''
*#'''<span style="color:#ff0000">Non-traumatic etiology</span>'''
* Natural history of untreated acute ischemic priapism includes days to weeks of painful erections followed by permanent loss of erectile function
*'''<span style="color:#ff0000">Duration of ischemic priapism is associated with the risk of future erectile dysfunction</span>'''
** In sickle cell disease patients in whom priapism was reversed, spontaneous erections (with or without use of sildenafil) were reported in:
*** '''100% when priapism was reversed by 12 hours'''
*** ≈'''75% when reversed by 12-24 hours'''
*** '''≈50% when reversed by 24-36 hours'''
*** '''0% when reversed ≥36 hours'''
***[https://pubmed.ncbi.nlm.nih.gov/18312286/ Bennett, Nelson, and John Mulhall. "Sickle cell disease status and outcomes of African-American men presenting with priapism." ''The journal of sexual medicine'' 5.5 (2008): 1244-1250.]
** '''A more recent study suggested that the cutoff for irreversible restoration of erectile tissue is 48 hours[https://pubmed.ncbi.nlm.nih.gov/23892191/]'''
** '''<span style="color:#ff0000">Interventions beyond 48-72 hours of onset may relieve erection and pain but have little benefit in preserving potency</span>'''