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Priapism Treatment in Gomti Nagar Extension, Lucknow – Swastik Urology Clinic
Swastik Urology Clinic provides emergency and advanced management for Priapism—a prolonged penile erection lasting more than 4 hours and unrelated to sexual stimulation. Under the care of Dr. Aditya Sengar (Urologist), we follow internationally accepted protocols to differentiate between ischemic (low-flow), non-ischemic (high-flow) and recurrent (stuttering) priapism and provide timely, evidence-based treatment. Early management is critical to prevent long-term erectile dysfunction.
What is Priapism?
Priapism is a persistent erection caused by abnormal blood flow within the
penis. It is classified into:
1. Ischemic (Low-Flow) Priapism – Medical Emergency
Caused by venous outflow obstruction leading to trapped, deoxygenated blood in the corpora cavernosa. It is painful and requires urgent treatment to prevent tissue damage.
2. Non-Ischemic (High-Flow) Priapism
Usually due to trauma causing uncontrolled arterial inflow. Typically painless and not an emergency but requires evaluation and interventional management.
3. Stuttering (Recurrent) Priapism
Repeated episodes of ischemic priapism commonly associated with sickle cell disease or neurological disorders. Preventive therapy is critical in such patients.
1. Ischemic (Low-Flow) Priapism – Medical Emergency
Caused by venous outflow obstruction leading to trapped, deoxygenated blood in the corpora cavernosa. It is painful and requires urgent treatment to prevent tissue damage.
2. Non-Ischemic (High-Flow) Priapism
Usually due to trauma causing uncontrolled arterial inflow. Typically painless and not an emergency but requires evaluation and interventional management.
3. Stuttering (Recurrent) Priapism
Repeated episodes of ischemic priapism commonly associated with sickle cell disease or neurological disorders. Preventive therapy is critical in such patients.
Ischemic (Low-Flow) Priapism
Characterized by painful, rigid erection due to obstructed venous
drainage. Cavernosal oxygen levels drop
rapidly, leading to acidosis and potential irreversible fibrosis if not
treated within 4–6 hours.
Non-Ischemic (High-Flow) Priapism
Usually painless, caused by arterial-lacunar fistula after trauma.
Cavernosal blood remains oxygenated,
reducing the risk of permanent damage. Often treated with selective
arterial embolization.
Stuttering Priapism (Recurrent Episodes)
Seen in sickle cell disease or neurological disorders. Frequent ischemic
episodes can cause permanent
damage. Preventive therapy includes hormonal modulation, PDE5 inhibitors
in controlled dosing, and
disease-specific management.
Medication or Drug-Induced Priapism
Certain injections (e.g., intracavernosal agents), antidepressants,
recreational drugs, and blood-related
conditions may trigger priapism and require urgent evaluation.
Causes & Risk Factors for Priapism
Common causes include:
1. Hematological Disorders – Sickle cell disease, leukemia.
2. Medications – Intracavernosal injections, antidepressants, antipsychotics.
3. Trauma – Perineal or penile injury causing arterial fistula.
4. Neurological Disorders – Spinal cord injury, pelvic nerve dysfunction.
5. Idiopathic – Many cases occur without identifiable cause.
Differentiating ischemic from non-ischemic priapism is essential because management strategies are completely different.
1. Hematological Disorders – Sickle cell disease, leukemia.
2. Medications – Intracavernosal injections, antidepressants, antipsychotics.
3. Trauma – Perineal or penile injury causing arterial fistula.
4. Neurological Disorders – Spinal cord injury, pelvic nerve dysfunction.
5. Idiopathic – Many cases occur without identifiable cause.
Differentiating ischemic from non-ischemic priapism is essential because management strategies are completely different.
Why Choose Swastik Urology Clinic for Priapism Treatment?
Swastik Urology Clinic provides rapid, structured and
guideline-based management of all forms
of priapism:
• Emergency Evaluation for Ischemic Priapism
Immediate cavernosal blood gas analysis, ultrasound and treatment initiation.
• Advanced Expertise – Dr. Aditya Sengar
Skilled in both minimally invasive and surgical management of priapism.
• Full Range of Treatment Options
Aspiration, irrigation, phenylephrine therapy, shunt procedures and embolization.
• Penile Rehabilitation After Priapism
Strategies to reduce long-term fibrosis and erectile dysfunction.
• Multidisciplinary Management
Especially for sickle cell disease, trauma and hematological causes.
• Emergency Evaluation for Ischemic Priapism
Immediate cavernosal blood gas analysis, ultrasound and treatment initiation.
• Advanced Expertise – Dr. Aditya Sengar
Skilled in both minimally invasive and surgical management of priapism.
• Full Range of Treatment Options
Aspiration, irrigation, phenylephrine therapy, shunt procedures and embolization.
• Penile Rehabilitation After Priapism
Strategies to reduce long-term fibrosis and erectile dysfunction.
• Multidisciplinary Management
Especially for sickle cell disease, trauma and hematological causes.
Priapism Treatment Options at Swastik Urology Clinic
Treatment depends on priapism type and duration:
1. Aspiration & Irrigation (First-Line for Ischemic Priapism)
• Removal of deoxygenated blood
• Saline irrigation to restore cavernosal oxygen levels
2. Intracavernosal Phenylephrine Injection
• FDA-recommended therapy for ischemic priapism
• Requires cardiac monitoring in selected patients
3. Surgical Shunt Procedures
• Winter, Ebbehoj, Al-Ghorab (distal shunts)
• Quackels or Sacher (proximal shunts)
• Used when first-line measures fail
4. Selective Arterial Embolization (High-Flow Priapism)
• Minimally invasive radiological technique
• Blocks arterial fistula responsible for persistent erection
5. Penile Prosthesis (Late Presentation Cases)
• For patients presenting after >24–48 hours with damaged erectile tissue
• Prevents severe penile fibrosis and deformity
6. Management of Stuttering Priapism
• Hormonal therapy
• PDE5 inhibitors (paradoxical low-dose use)
• Sickle cell disease-specific care
Timely intervention is the key to preserving erectile function and preventing complications.
1. Aspiration & Irrigation (First-Line for Ischemic Priapism)
• Removal of deoxygenated blood
• Saline irrigation to restore cavernosal oxygen levels
2. Intracavernosal Phenylephrine Injection
• FDA-recommended therapy for ischemic priapism
• Requires cardiac monitoring in selected patients
3. Surgical Shunt Procedures
• Winter, Ebbehoj, Al-Ghorab (distal shunts)
• Quackels or Sacher (proximal shunts)
• Used when first-line measures fail
4. Selective Arterial Embolization (High-Flow Priapism)
• Minimally invasive radiological technique
• Blocks arterial fistula responsible for persistent erection
5. Penile Prosthesis (Late Presentation Cases)
• For patients presenting after >24–48 hours with damaged erectile tissue
• Prevents severe penile fibrosis and deformity
6. Management of Stuttering Priapism
• Hormonal therapy
• PDE5 inhibitors (paradoxical low-dose use)
• Sickle cell disease-specific care
Timely intervention is the key to preserving erectile function and preventing complications.
How urgently should ischemic priapism be treated?
Ischemic priapism is a urological emergency. Treatment should ideally begin within 4–6 hours. Delayed treatment increases the risk of fibrosis, permanent erectile dysfunction and irreversible damage to penile tissue.
What happens if aspiration and phenylephrine fail?
If initial measures fail to resolve ischemic priapism, surgical shunt procedures are performed to create new drainage pathways. In refractory cases or prolonged presentations, early penile prosthesis placement may prevent severe fibrosis.
Does high-flow priapism need emergency treatment?
High-flow priapism is generally painless and non-ischemic. It does not require emergency management but should be evaluated. Selective arterial embolization is often effective when the condition does not resolve spontaneously.
What is the long-term outlook after priapism?
Long-term outcomes depend on duration before treatment. Early management preserves erectile function, while delayed treatment increases the risk of fibrosis and ED. Rehabilitation strategies and appropriate follow-up improve long-term results.