Which studies are performed in the workup of priapism?

Updated: Dec 26, 2019
  • Author: Osama Al-Omar, MD, MBA, FACS, FEBU; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Lab studies

  • Complete blood count (CBC): To determine if the patient has anemia, leukocytosis, or thrombocytosis
  • Plasma thromboplastin or activated partial thromboplastin time: To screen for coagulation abnormalities, as priapism may require surgical intervention if medical treatment fails
  • Blood type and hold: Exchange transfusion may be necessary to treat underlying sickle cell disease (SCD), a cause of low-flow priapism
  • Penile blood gas (PBG) measurement: Allows differentiation between high- and low-flow priapism
  • Psychoactive medication screening: Some antidepressant medications may cause priapism
  • Urine toxicology: Overdose of certain legal and illegal medications may cause priapism

Imaging studies

  • Penile duplex Doppler ultrasonography: To help identify and locate fistulas in patients with high-flow priapism
  • Pelvic angiography: To help confirm the fistula’s location
  • Chest radiography or computed tomography (CT) scanning: Used if the patient’s history is consistent with a malignant or metastatic condition

Other

Perform an electrocardiogram (ECG) if the patient is older than 55 years, has a history of cardiac disease, or is a possible surgical candidate.

See Workup for more detail.


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