Case history
Case history #1
A 41-year-old man presents to the emergency department with a painful penile erection of >24 hours' duration. The patient was recently started on a new insomnia medication by his family doctor. The patient has never had priapism before this presenting episode. On physical examination the penis is fully rigid.
Case history #2
A 7-year-old boy presents with a painless erection of 36 hours' duration. The patient sustained perineal trauma (straddle injury) 2 days before the priapism developed. Otherwise his medical history is unremarkable. Physical examination shows a complete erection of both corpora cavernosa with a flaccid corpus spongiosum. A small perineal haematoma is also noted.
Other presentations
Some patients may present with recurrent (sometimes called stuttering) priapism. Typically a patient may complain of priapism lasting <4 hours, which may occur weekly or fortnightly. Episodes are painful and commonly arise during nocturnal sleep, preceding or following sexual stimulation, and after morning erections. Episodes may escalate in frequency and/or duration. Erections typically detumesce on their own, although in some cases penile oedema and partial erection may remain.
Use of this content is subject to our disclaimer