Epidemiology

Priapism is associated with several different disease states, and numerous clinical contexts have risk associations for developing the disorder.[3][4][5]

Specific patient populations (neurologic conditions, hematologic dyscrasias, malignancies) constitute major risk categories for priapism. Sickle cell disease is the most common etiology of priapism in childhood, accounting for 65% of cases.[6] Among a large multicenter cohort of patients with sickle cell disease (n=1314), 14.3% of patients had experienced priapism (n=188).[7] The mean age of the first priapism episode was 16 years. Significant predictors of priapism in the cohort included increasing age (51 of 745 males younger than 18 years [6.9%] vs. 137 of 568 males 18 years old or older [24.1%]) and more severe sickle cell disease genotype (e.g., homozygous SS).[7] In one literature review (that returned 13 articles), reported priapism prevalence varied from 0.7% to 48% in patients (ages 7-30 years) with sickle cell disease.[8]

There is a need for greater awareness and education surrounding priapism among the medical community and the public.[5] One chart review found that only 5% of men presenting with priapism had ever been counseled or were aware that priapism is a complication of sickle cell disease.[9]

Vasoactive agents (e.g., sildenafil, tadalafil) used to treat erectile dysfunction may cause priapism, but drug-induced priapism may also be attributed to antipsychotics and antidepressants.[10] Second-generation antipsychotics (33.8%), other medications (11.3%), and alpha-adrenergic antagonists (8.8%) account for most reported cases of drug-induced priapism.[10]

There are few epidemiologic studies conducted outside at-risk populations. There are, however, some data to suggest that incidence rates of priapism in the general population range between 0.3 and 1.5 per 100,000 per year.[11][12]

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