Yafi Faysal A, April Daniel, Powers Mary K, Sangkum Premsant, Hellstrom Wayne J G
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Sex Med Rev. 2015 Jul;3(3):145-159. doi: 10.1002/smrj.51. Epub 2015 Oct 8.
Priapism is a persistent erection that arises from a dysfunction of the normal regulatory mechanisms of penile tumescence, rigidity, and flaccidity. It is defined as an erection lasting longer than 6 hours that is not related to sexual stimulation. There are three types of priapism: ischemic, non-ischemic, and stuttering. Similarly, clitoral priapism may occur in females manifested by symptoms such as engorgement with pain and swelling of the clitoris and surrounding tissue. Persistent genital arousal disorder (PGAD) is uncontrollable genital arousal in females, with or without orgasms, that occurs spontaneously and without any sexual feelings.
The aim of this article is to review the available literature on priapism, clitoral priapism, and PGAD.
A literature review was performed through PubMed regarding priapism, clitoral priapism, and PGAD.
The main outcome is an assessment of the potential etiologies, pathophysiology, diagnostic tools, and management options (medical and surgical) for these conditions.
Initial workup of priapism should include a thorough history, physical examination, and cavernous arterial blood gas measurement. Findings should guide further management depending on the etiology of priapism (ischemic vs. non-ischemic). For ischemic priapism, a widely used therapeutic algorithm has been described. For patients with stuttering priapism, multiple oral therapies are currently available. Most reported cases of clitoral priapism appear to be drug-induced, and the primary treatment is stopping the offending agent. Medications like phenylpropanolamine and phenylephrine can also be utilized. PGAD may be associated with anatomical abnormalities, such as Tarlov cysts for which an epidural anesthesia block may be considered.
Early recognition and diagnosis of priapism is paramount to preserving erectile function. Current treatment regimens for ischemic priapism have room for innovation in both pharmacological and surgical therapies. Further investigation into the etiologies and treatment options for clitoral priapism and PGAD are required. Yafi FA, April D, Powers MK, Sangkum P, and Hellstrom WJG. Penile priapism, clitoral priapism, and persistent genital arousal disorder: A contemporary review. Sex Med Rev 2015;3:145-159.
阴茎异常勃起是一种由于阴茎勃起、坚挺和疲软的正常调节机制功能障碍而导致的持续性勃起。它被定义为持续时间超过6小时且与性刺激无关的勃起。阴茎异常勃起有三种类型：缺血性、非缺血性和间歇性。同样，阴蒂异常勃起可能发生在女性身上，表现为阴蒂及周围组织充血、疼痛和肿胀等症状。持续性性唤起障碍（PGAD）是女性无法控制的性唤起，无论有无性高潮，都会自发出现且没有任何性感觉。
本文的目的是综述关于阴茎异常勃起、阴蒂异常勃起和PGAD的现有文献。
通过PubMed对阴茎异常勃起、阴蒂异常勃起和PGAD进行文献综述。
主要观察结果是对这些病症的潜在病因、病理生理学、诊断工具和治疗选择（药物和手术）进行评估。
阴茎异常勃起的初始检查应包括详细的病史、体格检查和海绵体动脉血气测量。根据阴茎异常勃起的病因（缺血性与非缺血性），检查结果应指导进一步的治疗。对于缺血性阴茎异常勃起，已经描述了一种广泛使用的治疗方案。对于间歇性阴茎异常勃起患者，目前有多种口服治疗方法。大多数报道的阴蒂异常勃起病例似乎是药物引起的，主要治疗方法是停用致病药物。也可以使用苯丙醇胺和去氧肾上腺素等药物。PGAD可能与解剖学异常有关，如塔尔洛夫囊肿，对此可考虑进行硬膜外麻醉阻滞。
阴茎异常勃起的早期识别和诊断对于保留勃起功能至关重要。目前缺血性阴茎异常勃起的治疗方案在药物和手术治疗方面都有创新的空间。需要对阴蒂异常勃起和PGAD的病因及治疗选择进行进一步研究。Yafi FA、April D、Powers MK、Sangkum P和Hellstrom WJG。阴茎异常勃起、阴蒂异常勃起和持续性性唤起障碍：当代综述。性医学评论2015；3：145 - 159。
