Snapshot A 32-year-old man with history of sickle cell disease presents to the emergency department complaining of penile discomfort. He reports that he has had a persistent, painful erection for the last 5 hours. On physical exam, the penis is painful and rigid. Urology is consulted and who promptly takes him for aspiration and irrigation. Introduction Priapism is a prolonged penile erection lasting greater than 4-6 hours in the absence of sexual stimulation Urologic emergency Often associated with medications (oral phosphodiesterase-5 inhibitors, trazadone), sickle cell disease, or leukemia Two types: login to view 6 more bullets Presentation Symptoms login to view 2 more bullets Physical exam login to view 7 more bullets Differential Paraphimosis login to view 2 more bullets Evaluation Generally a clinical diagnosis Corpora cavernosa blood analysis login to view 2 more bullets Penile doppler ultrasonography login to view 1 more bullet Treatment Ischemic (low flow) priapism login to view 3 more bullets Nonischemic (high flow) priapism can be initially observed Complications Prolonged episodes >24-48 hours can result in necrosis, leading to erectile dysfunction Prognosis Good, most episodes resolve and have return to baseline function Prevention: login to view 2 more bullets