Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.
Department of Urology, St. James University Hospital, Leeds, UK.
Eur Urol. 2014 Feb;65(2):480-9. doi: 10.1016/j.eururo.2013.11.008. Epub 2013 Nov 16.
Priapism is defined as a penile erection that persists beyond or is unrelated to sexual interest or stimulation. It can be classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent or intermittent).
To provide guidelines on the diagnosis and treatment of priapism.
Systematic literature search on the epidemiology, diagnosis, and treatment of priapism. Articles with highest evidence available were selected to form the basis of these recommendations.
Ischaemic priapism is usually idiopathic and the most common form. Arterial priapism usually occurs after blunt perineal trauma. History is the mainstay of diagnosis and helps determine the pathogenesis. Laboratory testing is used to support clinical findings. Ischaemic priapism is an emergency condition. Intervention should start within 4-6h, including decompression of the corpora cavernosa by aspiration and intracavernous injection of sympathomimetic drugs (e.g. phenylephrine). Surgical treatment is recommended for failed conservative management, although the best procedure is unclear. Immediate implantation of a prosthesis should be considered for long-lasting priapism. Arterial priapism is not an emergency. Selective embolization is the suggested treatment modality and has high success rates. Stuttering priapism is poorly understood and the main therapeutic goal is the prevention of future episodes. This may be achieved pharmacologically, but data on efficacy are limited.
These guidelines summarise current information on priapism. The extended version are available on the European Association of Urology Website (www.uroweb.org/guidelines/).
Priapism is a persistent, often painful, penile erection lasting more than 4h unrelated to sexual stimulation. It is more common in patients with sickle cell disease. This article represents the shortened EAU priapism guidelines, based on a systematic literature review. Cases of priapism are classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent). Treatment for ischaemic priapism must be prompt in order to avoid the risk of permanent erectile dysfunction. This is not the case for arterial priapism.
阴茎异常勃起是指一种持续时间超过或与性兴趣或刺激无关的阴茎勃起。它可以分为缺血性（低流量）、动脉性（高流量）或痉挛性（复发性或间歇性）。
提供阴茎异常勃起的诊断和治疗指南。
对阴茎异常勃起的流行病学、诊断和治疗进行系统文献检索。选择具有最高证据的文章作为这些建议的基础。
缺血性阴茎异常勃起通常是特发性的，也是最常见的形式。动脉性阴茎异常勃起通常发生在钝性会阴部创伤后。病史是诊断的主要依据，并有助于确定发病机制。实验室检查用于支持临床发现。缺血性阴茎异常勃起是一种紧急情况。干预应在 4-6 小时内开始，包括通过抽吸使海绵体减压和向海绵体内注射拟交感神经药物（如苯肾上腺素）。对于保守治疗失败的病例，建议进行手术治疗，尽管最佳手术方法尚不清楚。对于持久的阴茎异常勃起，应考虑立即植入假体。动脉性阴茎异常勃起不是紧急情况。建议采用选择性栓塞作为治疗方式，且成功率较高。痉挛性阴茎异常勃起的理解较差，主要的治疗目标是预防未来发作。这可以通过药物治疗来实现，但疗效数据有限。
这些指南总结了当前关于阴茎异常勃起的信息。扩展版本可在欧洲泌尿外科学会网站（www.uroweb.org/guidelines/）上获得。
阴茎异常勃起是一种持续时间超过 4 小时的、通常是疼痛的、与性刺激无关的阴茎勃起。镰状细胞病患者更为常见。本文代表了基于系统文献回顾的 EAU 阴茎异常勃起指南的简化版。阴茎异常勃起病例分为缺血性（低流量）、动脉性（高流量）或痉挛性（复发性）。为了避免永久性勃起功能障碍的风险，缺血性阴茎异常勃起的治疗必须及时。动脉性阴茎异常勃起则并非如此。
