American Urological Association - Priapism and Strangulation
Priapism and Strangulation
- 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).
- 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.