What are the risk factors for priapism?

From the Guidelines

Priapism is a condition with several risk factors, including sickle cell disease, hematologic disorders, and the use of certain medications or drugs.

Risk Factors for Priapism

• Sickle cell disease: a significant risk factor for priapism, particularly acute ischemic priapism 1
• Hematologic disorders: such as chronic myelogenous leukemia, can increase the risk of priapism 1
• Psychoactive drugs and substances: may contribute to the development of priapism, although testing for these substances may have a high rate of false negativity 1
• Malignancy: underlying malignancy, such as leukemia, may be identified through laboratory evaluation, including a complete blood count 1
• Hormonal regulators: may impair fertility and sexual function in patients with recurrent ischemic priapism 1

Important Considerations

• Urologic relief: patients presenting with sickle cell disease and acute ischemic priapism should initially be managed with a focus on urologic relief of the erection 1
• Prompt intracavernosal phenylephrine: may be used to relieve episodes of acute ischemic priapism in men with hematologic disorders 1

From the Research

Risk Factors for Priapism

The following are risk factors for priapism:

• History of previous recurrent attacks of priapism 2, 3
• Use of certain medications, such as:
  • Antipsychotic medications 2, 4
  • Vasodilating agents 4
  • HIV medications 4
• Presence of certain medical conditions, such as:
  • Sickle cell disease 3
  • Hereditary anemias 4
  • Hemolytic anemias 4
  • HIV disease 4
• Drug abuse or psychiatric disease 3
• Erectile dysfunction history 3
• Prolonged priapism (> 48 h) 5
• Failure to maintain complete detumescence after management 5
• Marked penile fibrosis during follow-up 5

Patient Characteristics

Patients with certain characteristics are at higher risk for priapism, including:

• Age: the average age at first presentation was 39 ± 18 years 3
• Race: 40% of patients were black 3
• Insurance status: patients with other than commercial medical insurance were at higher risk for readmission 3