What is the prognosis 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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Prognosis depends on the duration of symptoms, the patient's age, and the underlying pathology. The duration of symptoms is the single most important factor affecting outcome. A Scandinavian study reported that 92% of patients with priapism for less than 24 hours remained potent, while only 22% of patients with priapism that lasted longer than 7 days remained potent. [3]

All patients with priapism should be warned about the long-term risk of erectile dysfunction. The warning should also be clearly written on the discharge instruction sheet and documented in the chart. In general, vaso-occlusive priapism poses a higher risk of impotence than high-flow arterial priapism. Sickle cell disease appears to particularly increase risk: a study by Anele and Burnett found that patients with sickle cell disease who experience even minor episodes of recurrent ischemic priapism are five times more likely to develop erectile dysfunction compared with non–sickle cell patients. [19]

Patients who have experienced an episode of priapism are at risk for recurrence. A review of 3,372 men who presented to emergency departments with priapism found that within 1 year, 24% of patients were readmitted for recurrent priapism. Of those, 68% were readmitted within 60 days. [20]

Infection can complicate priapism. In cases resulting from trauma, the source of the infection may be the trauma itself, or it may be iatrogenic. Corporeal fibrosis due to persistent priapism can result in deep-tissue infections of the penis.

Deaths have been reported in patients with sickle cell disease presenting with priapism, but the cause of death usually is not related to the priapism per se but to complications from the underlying disease process.

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