Editing Priapism (section)

=== Non-ischemic priapism (arterial, high-flow) ===
* '''<span style="color:#ff0000">Relatively rare</span>'''
* May last hours to weeks and is frequently recurrent
*'''<span style="color:#ff0000">Pathogenesis:</span>'''
** Likely results from unregulated control of arterial inflow and cavernous smooth muscle tone
**'''<span style="color:#ff0000">Usually involves perineal or penile trauma</span>''' '''resulting in laceration of the cavernous artery (or one of its branches within the corpora)''' '''and unregulated cavernous arterial inflow.'''
*** '''<span style="color:#ff0000">Most common cause is a straddle injury</span>''' to the crura
**** '''Other mechanisms of traumatic arterial laceration include''' coital trauma, kicks to the penis or perineum, pelvic fractures, birth canal trauma to the male newborn, needle lacerations, iatrogenic needle injury, complications of penile diagnostics, vascular erosions complicating metastatic infiltration of the corpora, and after iatrogenic trauma from coldknife urethrotomy, corporoplasty, and penile revascularization procedures
***** '''Sustained partial erection may develop 24 hours after perineal or penile blunt trauma'''
***'''The arteriolacunar fistula is typically unilateral'''.
** '''<span style="color:#ff0000">After either aggressive medical management of ischemic priapism or surgical shunting, priapism may rapidly recur with conversion from ischemic (low-flow) to non-ischemic (high-flow)'''
** '''Other causes include Fabry disease and sickle cell anemia'''
* '''<span style="color:#ff0000">Associated with</span>''' (features that distinguish this from ischemic priapism)
*# '''<span style="color:#ff0000">Lack of pain</span>''' (beyond pain from potential acute traumatic etiology)
*# '''<span style="color:#ff0000">Tumescent but less rigid corpora cavernosa</span>'''
*#* '''<span style="color:#ff0000">Erection is partial and bendable because there is no restriction of venous outflow,</span>'''
*#* '''Patients do report additional engorgement with sexual stimulation, with return to partial erection after climax'''
*# '''<span style="color:#ff0000">Normal penile blood gas</span>''' (features that distinguish this from non-ischemic priapism)
*#'''<span style="color:#ff0000">Once properly diagnosed, does not require emergent intervention</span>'''
*#'''<span style="color:#ff0000">Traumatic etiology, usually</span>'''