Home Education AUAUniversity Education Products & Resources Pathology for Urologists Penis Congenital/Anatomical Defects Priapism and Strangulation

Priapism and Strangulation

Image A

Image B


  • Prolonged erection unrelated to sexual desire.
  • Pain and tenderness usually result after 6-8 hours and are related to ensuing ischemia (image A).
  • Etiology: primary or secondary (trauma, thromboembolism, hemostasis, neurologic defects, cancer, drugs, other).
  • Histology.
    • Corpora are edematous, indurated, and ultimately sclerotic.
    • By 12 hours: edema.
    • By 24 hours: destruction of the sinusoidal endothelium and exposure of the basement membrane with adherence of platelets.
    • By 48 hours: vascular thrombi associated with ischemic necrosis of the smooth muscle.


  • Prolonged erection resulting from obstruction of the venous outflow (image B), due to the application of some constricting device.
  • Etiology: stupidity? curiosity? unusual practices?
  • Histologic feature: essentially the same as priapism.