Priapism Emergency Treatment: Ischemic, Non-ischemic, Recurrent
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Emergency Department Management of Priapism (Pharmacology CME)

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Table of Contents
Table of Contents
  1. Abstract
  2. Case Presentations
  3. Introduction
  4. Critical Appraisal of the Literature
  5. Etiology And Pathophysiology
    1. Ischemic Priapism
    2. Nonischemic Priapism
    3. Recurrent Ischemic Priapism
  6. Differential Diagnosis
  7. Prehospital Care
  8. Emergency Department Evaluation
    1. History
    2. Physical Examination
  9. Diagnostic Studies
    1. Corporal Blood Gas Testing
    2. Penile Color Duplex Ultrasonography
    3. Laboratory Analysis
  10. Treatment
    1. Surgery
    2. Treatment Of Recurrent Ischemic Priapism
    3. Treatment Of High-Flow Priapism
  11. Special Populations
    1. Elderly Patients And Patients With Cardiovascular Disease
    2. Pediatric Patients
    3. Patients With Inflatable Penile Prosthesis
  12. Controversies And Cutting Edge
  13. Disposition
    1. Resolved Ischemic Priapism
    2. Unresolved Ischemic Priapism
    3. High-Flow And Stuttering Priapism
  14. Summary
  15. Risk Management Pitfalls For Management Of Priapism
  16. Time- And Cost-Effective Strategies
  17. Case Conclusions
  18. Clinical Pathway For The Management Of Priapism
  19. Tables And Figures
    1. Figure 1. Cross-Section Of The Human Penis
    2. Figure 2. Visual Depiction Of Erectile Physiology
    3. Figure 3. Longitudinal Color Duplex Ultrasonography In High-Flow Priapism
    4. Figure 4. Two Approaches To Aspiration Of The Corpus Cavernosum
    5. Figure 5. Schematic Of Inflatable Penile Prosthesis
    6. Table 1. Differential Diagnosis For Priapism
    7. Table 2. Key Distinguishing Features Of Priapism
  20. References


Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. Evidence-based management and appropriate urologic follow-up of nonischemic and recurrent ischemic priapism maximizes patient outcomes and resource utilization.

Case Presentations

A 53-year-old man with a history of hemoglobin SS (HbSS) sickle cell disease presents with 5 hours of a persistent, painful erection. This is the third time this has occurred in the past 2 years. Prior to presentation, he took pseudoephedrine tablets that were prescribed by his urologist, with no improvement. He denies fevers, chills, or trauma. He appears to be in a moderate amount of pain and his physical examination is notable for a fully erect penis that is tender to palpation, without lesions or discharge. You wonder: How long does it take for irreversible tissue damage to occur?

As you are deciding on your first course of action, the paramedics bring in a 22-year-old man who was just in a bicycle accident. He had a flat tire that caused him to fall on his bicycle, striking his groin on the handle bars. He was wearing a helmet, did not lose consciousness, and has no neck tenderness. His examination is otherwise normal, apart from superficial abrasions to his extremities and a semirigid phallus that is more embarrassing than painful to him. It persists despite his attempts to apply local pressure. After performing a more detailed physical examination, you note that there is some bruising and swelling to his perineum and the base of his penis. His testicles are mildly tender, but the cremasteric reflex is present bilaterally. You note no blood at the meatus. You have never seen anything like this, and you wonder: What are your priorities for the diagnosis and management of this patient?


Genitourinary complaints account for approximately 5% of emergency department (ED) visits in the United States,and one of the most serious of these emergencies is a man presenting with priapism.1,2 Priapism is defined as a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation.3,4 There are 3 main types of priapism:

  • Ischemic (also referred to as “low-flow” priapism)
  • Nonischemic (also referred to as “high-flow” priapism)
  • Recurrent ischemic priapism (also referred to as “intermittent” or “stuttering” priapism)

Ischemic priapism represents a penile compartment syndrome, thus making it a true emergency requiring rapid intervention. Ischemic changes begin within 12 hours of a maintained erection, beginning with interstitial edema that progresses to denuding of the sinusoidal endothelium and thrombocyte adhesion at 24 hours. After approximately 48 hours, smooth-muscle necrosis occurs, and fibroblast-type cells proliferate.After 48 hours of ischemic priapism, 100% of patients develop some level of irreversible fibrosis of the corpus cavernosum that negatively affects their erectile function and can lead to permanent impotence.

The incidence of ischemic priapism ranges from 1 to 5 cases in 100,000 men, though it is higher in subsets of the population, particularly in men with sickle cell disease.6,7 The lifetime risk of ischemic priapism for a man with sickle cell disease is 29% to 42%.8

The diagnosis and management of priapism is a core competency of the emergency clinician. This issue of Emergency Medicine Practice provides a review of the literature and best-practice recommendations on how to manage this condition and optimize patient outcomes.

Critical Appraisal Of The Literature

A literature search was performed using PubMed and the Cochrane Database of Systematic Reviews with the search terms priapism, ischemic, high flow, stuttering, impotence, and sickle cell. From the Cochrane library, 69 trials involving priapism were identified. A Cochrane review regarding priapism in which only 1 study met inclusion criteria was found,and, not surprisingly, no conclusions regarding the benefits and risks of the different treatments for both stuttering and fulminant priapism in males with sickle cell disease could be drawn.9

The majority of literature on priapism consists of case reports, case series of well-established therapies, retrospective chart reviews, and position papers. Both the European Association of Urology (EAU)and the American Urological Association Guidelines Committeehave published practice guidelines based on a panel of expert opinions. Recently, there have been several review articles summarizing treatment guidelines and practice standards.10-13 There are ongoing studies describing experimental therapies for recurrent and fulminant priapism.14 The 2014 EAU guidelines remain the most current and comprehensive literature summary to date; it included 192 review articles, 485 original articles, and 911 case reports.

Risk Management Pitfalls For Management Of Priapism

  1. “My patient clearly had high-flow priapism and was comfortable for discharge, so I didn’t run the case by the urologist.”
    Despite the low risk of long-term erectile dysfunction with nonischemic priapism, emergency clinicians should discuss the case with an urologist to establish close follow-up.
  2. “I had a patient with sickle cell disease and a bedside Doppler ultrasound consistent with ischemic priapism. That’s why I didn’t perform a blood gas analysis.”
    Color Doppler ultrasound is a useful diagnostic adjunct, but should not replace blood gas analysis in ischemic priapism. Note that it is recommended to perform color Doppler ultrasound in cases of penile trauma.
  3. “My patient with sickle cell disease told me that all he needed for his priapism to resolve was some fluid, oxygen, and pain control. I didn’t want to perform an invasive procedure if he didn’t need it.”
    Definitive therapy for priapism means inserting a needle into the corpus cavernosum. You can supplement your management of ischemic priapism with fluids and oxygen, but these therapies should neither delay nor take the place of aspiration and penile injection.
  4. “My patient had a clear history of using an intracavernosal vasoactive medication about 5 hours ago. That’s why I went straight to injection with phenylephrine.”
    Despite an accurate history, the exact etiology will not be elucidated until more data are collected. Furthermore, progressing down the algorithm of aspiration and irrigation minimizes the potential systemic side effects of phenylephrine. Cold saline has been shown to be effective in up to 96% of cases of priapism resulting from intracavernosal injection of vasoactive medication.
  5. “I had a pediatric patient with priapism and I recall phenylephrine being the drug of choice for injection. Do I need to modify the dose?”
    Phenylephrine is the drug of choice in children 11 years and older. Make sure to use a dilute solution of 100 mcg/mL and use 1 mL at a time. Remember that epinephrine is the drug of choice for younger patients. Use dilute epinephrine, 1 mcg/mL, to irrigate the corpora in boys between the ages of 2 and 11 years. Consult a specialist for children younger than 2 years.
  6. “My patient achieved detumescence after just 1 round of phenylephrine. We were very busy that day, and he was a young patient, so I discharged him expeditiously.”
    Remember that if you inject the corpus cavernosum with a vasoactive agent, it is recommended to observe the patient for at least 1 hour. This also helps assure that your therapy was definitive and priapism does not reoccur.
  7. “After aspiration of the corpus cavernosum, the patient detumesced. I withdrew the needle and asked the nurse to apply a compressive dressing. The patient developed a hematoma. Why?”
    After you withdraw the needle, apply firm pressure to the aspiration site to prevent hematoma formation. Place the dressing yourself, with ample gauze around the glans. You can place an ice pack over the gauze and use an adult diaper to keep everything in place.
  8. “I was about to insert the needle, but I realized that the patient had an inflated penile prosthesis.”
    Although abnormal erections secondary to implantable prostheses are usually not painful and patients are usually aware of them, this scenario highlights the importance of performing a through history and physical examination before proceeding with treatment.
  9. “I had a patient present after having priapism for 48 hours. I still proceeded with the usual treatment algorithm.”
    Patients who present after 36 hours of priapism should have immediate urologic consultation for consideration of placement of a penile prosthesis even if detumescence is achieved in the ED.
  10. “The patient was in excruciating pain, so I began the aspiration without anesthesia. I was saving him an extra needle stick.”
    Taking the time to properly anesthetize the penis (preferably using ultrasound guidance) before aspiration will save the patient pain and discomfort later, especially if another aspiration approach or surgical shunt is required. If you wish to save the patient an extra needle stick, start with an 18-gauge angiocath and leave the catheter in place while you obtain blood gas samples; aspirate, and irrigate if necessary.

Tables And Figures

Table 1. Differential Diagnosis For Priapism


Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study is included in bold type following the reference, where available. The most informative references cited in this paper, as determined by the authors, are noted by an asterisk (*) next to the number of the reference.

  1. Pitts SR, Niska RW, Xu J, et al. National hospital ambulatory medical care survey: 2006 emergency department summary. National health statistics report; no. 7. Hyattsville, MD: National Center for Health Statistics. 2008. (Population study)
  2. Serjeant GR, de Ceulaer K, Maude GH. Stilboestrol and stuttering priapism in homozygous sickle-cell disease. Lancet. 1985;2(8467):1274-1276. (Double blind, placebo-controlled crossover study; 11 patients)
  3. * Montague DK, Jarow J, Broderick GA, et al. American Urological Association guideline on the management of priapism. J Urol. 2003;170(4 Pt 1):1318-1324. (Consensus panel)
  4. * Salonia A, Eardley I, Giuliano F, et al. European Association of Urology guidelines on priapism. Eur Urol. 2014;65(2):480- 489. (Systematic literature review; consensus panel)
  5. Spycher MA, Hauri D. The ultrastructure of the erectile tissue in priapism. J Urol. 1986;135(1):142-147. (Observational report)
  6. Eland IA, van der Lei J, Stricker BHC, et al. Incidence of priapism in the general population. Urology. 2001;57(5):970-972. (Population-based retrospective cohort study; 145,071 men)
  7. Roghmann F, Becker A, Sammon JD, et al. Incidence of priapism in emergency departments in the United States. J Urol. 2013;190(4):1275-1280. (Retrospective cohort study; 34,462 pts [weighted estimate])
  8. Emond AM, Holman R, Hayes RJ, et al. Priapism and impotence in homozygous sickle cell disease. Arch Intern Med. 1980;140(11):1434-1437. (Retrospective cohort study; 104 patients)
  9. Chinegwundoh FI, Anie KA. Treatments for priapism in boys and men with sickle cell disease. Cochrane Database Syst Rev. 2004;18(4):CD004198. (Cochrane review; 11 studies, 1 inclusion)
  10. Montorsi F, Adaikan G, Becher E, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2010;7(11):3572-3588. (Literature review; expert opinion)
  11. Donaldson JF, Rees RW, Steinbrecher HA. Priapism in children: a comprehensive review and clinical guideline. J Pediatr Urol. 2014;10(1):11-24. (Systematic literature review; 337 abstracts)
  12. * Levey HR, Segal RL, Bivalacqua TJ. Management of priapism: an update for clinicians. Ther Adv Urol. 2014;6(6):230- 244. (Expert opinion)
  13. Burnett AL, Bivalacqua TJ. Priapism: current principles and practice. Urol Clin North Am. 2007;34(4):631-642. (Expert opinion)
  14. Olujohungbe AB, Adeyoju A, Yardumian A, et al. A prospective diary study of stuttering priapism in adolescents and young men with sickle cell anemia: report of an international randomized control trial--the priapism in sickle cell study. J Androl. 2011;32(4):375-382. (Randomized control trial; 46 patients)
  15. Yucel S, Baskin LS. Identification of communicating branches among the dorsal, perineal and cavernous nerves of the penis. J Urol. 2003;170(1):153-158. (Observational; 18 specimens)
  16. Flores S, Herring AA. Ultrasound-guided dorsal penile nerve block for ED paraphimosis reduction. Am J Emerg Med. 2015;33(6):863.e863-e865. (Case report)
  17. Andersson KE. Mechanisms of penile erection and basis for pharmacological treatment of erectile dysfunction. Pharmacol Rev. 2011;63(4):811-859. (Literature review; expert opinion)
  18. Aboseif SR, Lue TF. Hemodynamics of penile erection. Urol Clin North Am. 1988;15(1):1-7. (Descriptive study)
  19. Anele UA, Le BV, Resar LM, et al. How I treat priapism. Blood. 2015;125(23):3551-3558. (Expert opinion)
  20. Berger R, Billups K, Brock G, et al. Report of the American Foundation for Urologic Disease (AFUD) Thought Leader Panel for evaluation and treatment of priapism. Int J Impot Res. 2001;13 Suppl 5:S39-S43. (Consensus panel; modified Delphi method)
  21. Broderick GA, Harkaway R. Pharmacologic erection: time-dependent changes in the corporal environment. Int J Impot Res. 1994;6(1):9-16. (Observational study; 14 patients)
  22. Campbell MF, Walsh PC, Retik AB. Campbell’s Urology. Philadelphia, PA: Elsevier. 2002. (Textbook)
  23. * Broderick GA, Kadioglu A, Bivalacqua TJ, et al. Priapism: pathogenesis, epidemiology, and management. J Sex Med. 2010;7(1 Pt 2):476-500. (Expert opinion; literature review)
  24. Burnett AL. Sexual health outcomes improvement in sickle cell disease: a matter of health policy? J Sex Med. 2012;9(1):104-113. (Expert opinion; literature review)
  25. Ekeke ON, Omunakwe HE, Eke N. Management of priapism in adult men. Int Surg. 2015;100(3):552-557. (Retrospective cohort study; 18 patients)
  26. Levey HR, Kutlu O, Bivalacqua TJ. Medical management of ischemic stuttering priapism: a contemporary review of the literature. Asian J Androl. 2012;14(1):156-163. (Expert opinion)
  27. Adeyoju AB, Olujohungbe ABK, Morris J, et al. Priapism in sickle-cell disease; incidence, risk factors and complications – an international multicentre study. BJU International. 2002;90(9):898-902. (Retrospective cohort study; 130 patients)
  28. Bertolotto M, Calderan L, Cova MA. Imaging of penile traumas--therapeutic implications. Eur Radiol. 2005;15(12):2475- 2482. (Expert opinion)
  29. Todd NV. Priapism in acute spinal cord injury. Spinal Cord. 2011;49(10):1033-1035. (Prospective literature review)
  30. Morrison BF, Burnett AL. Priapism in hematological and coagulative disorders: an update. Nat Rev Urol. 2011;8(4):223- 230. (Descriptive study)
  31. Lee DJ, Najari BB, Davison WL, et al. Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States. J Sex Med. 2015;12(7):1638-1645. (Retrospective cohort study; 53,180 patients)
  32. Kojima H, Tanigawa N, Kariya S, et al. High-flow priapism undergoing arterial embolization: review of literature following American Urological Association guideline on the management of priapism. Minim Invasive Ther Allied Technol. 2009;18(1):1-5. (Case report; literature review)
  33. Sood S, James W, Bailon MJ. Priapism associated with atypical antipsychotic medications: a review. Int Clin Psychopharmacol. 2008;23(1):9-17. (Literature review)
  34. Bawaskar H, Bawaskar P. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: randomised open label clinical trial. BMJ (Clinical research ed.). 2011;342(7789):153. (Randomized control trial; 70 patients)
  35. Backenroth R, Landau EH, Goren M, et al. Fabry disease and G6PD in three family members with priapism: is the nitric oxide pathway to blame? J Sex Med. 2010;7(4 Pt 1):1588-1591. (Case reports)
  36. Dent LA, Brown WC, Murney JD. Citalopram-induced priapism. Pharmacotherapy. 2002;22(4):538-541. (Case report)
  37. * Ateyah A, Rahman El-Nashar A, Zohdy W, et al. Intracavernosal irrigation by cold saline as a simple method of treating iatrogenic prolonged erection. J Sex Med. 2005;2(2):248-253. (Randomized control trial; 122 patients)
  38. Habous M, Elkhouly M, Abdelwahab O, et al. Noninvasive treatments for iatrogenic priapism: do they really work? A prospective multicenter study. Urol Ann. 2016;8(2):193-196. (Prospective multicenter study; 369 patients)
  39. Muneer A, Minhas S, Freeman A, et al. Investigating the effects of high-dose phenylephrine in the management of prolonged ischaemic priapism. J Sex Med. 2008;5(9):2152- 2159. (Observational study; 6 patients)
  40. Burnett AL, Sharlip ID. Standard operating procedures for priapism. J Sex Med. 2013;10(1):180-194. (Literature review)
  41. Bertolotto M, Zappetti R, Pizzolato R, et al. Color Doppler appearance of penile cavernosal-spongiosal communications in patients with high-flow priapism. Acta Radiol. 2008;49(6):710-714. (Observational study; 12 patients)
  42. Bochinski DJ, Dean RC, Lue TF. Erectile dysfunction and priapism. Nat Clin Pract Urol. 2004;1(1):49-53. (Observational study)
  43. Avery LL, Scheinfeld MH. Imaging of penile and scrotal emergencies. Radiographics. 2013;33(3):721-740. (Review)
  44. Bhatt S, Kocakoc E, Rubens DJ, et al. Sonographic evaluation of penile trauma. J Ultrasound Med. 2005;24(7):993-1000. (Pictorial review)
  45. Wilkins CJ, Sriprasad S, Sidhu PS. Colour Doppler ultrasound of the penis. Clin Radiol. 2003;58(7):514-523. (Pictorial review)
  46. Long RM, McCartan D, Cullen I, et al. A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision. BJU Int. 2010;105(11):1576-1578. (Observational study; 13 patients)
  47. * Lander J, Brady-Fryer B, Metcalfe JB, et al. Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision: a randomized controlled trial. JAMA. 1997;278(24):2157-2162. (Randomized control trial; 52 patients)
  48. * Dittrich A, Albrecht K, Bar-Moshe O, et al. Treatment of pharmacological priapism with phenylephrine. J Urol. 1991;146(2):323-324. (Observational study; 36 patients)
  49. Siegel JF, Reda E. Intracorporeal phenylephrine reduces thioridazine (Mellaril) induced priapism in a child. J Urol. 1997;157(2):648. (Case report)
  50. * Roberts JR, Price C, Mazzeo T. Intracavernous epinephrine: a minimally invasive treatment for priapism in the emergency department. J Emerg Med. 2009;36(3):285-289. (Case report series; 4 patients)
  51. * Munarriz R, Wen CC, McAuley I, et al. Management of ischemic priapism with high-dose intracavernosal phenylephrine: from bench to bedside. J Sex Med. 2006;3(5):918-922. (Retrospective cohort study; 17 patients, 2 case reports)
  52. Jiang P, Christakos A, Fam M, et al. Prophylactic phenylephrine for iatrogenic priapism: a pilot study with Peyronie’s patients. Korean J Urol. 2014;55(10):665-669. (Retrospective chart review; 44 patients)
  53. * Muruve N, Hosking DH. Intracorporeal phenylephrine in the treatment of priapism. J Urol. 1996;155(1):141-143. (Retrospective chart review; 9 patients)
  54. Bertram RA, Carson CC 3rd, Webster GD. Implantation of penile prostheses in patients impotent after priapism. Urology. 1985;26(4):325-327. (Retrospective chart review; 6 patients)
  55. Tausch TJ, Zhao LC, Morey AF, et al. Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism. J Sex Med. 2015;12(3):824-826. (Retrospective chart review; 14 patients)
  56. Ballas SK, Lyon D. Safety and efficacy of blood exchange transfusion for priapism complicating sickle cell disease. J Clin Apher. 2016;31(1):5-10. (Prospective cohort study; 9 patients)
  57. Shamloul R, el Nashaar A. Idiopathic stuttering priapism treated successfully with low-dose ethinyl estradiol: a single case report. J Sex Med. 2005;2(5):732-734. (Case report)
  58. Migliorini F, Porcaro AB, Baldassarre R, et al. Idiopathic stuttering priapism treated with salbutamol orally: a case report. Andrologia. 2016;48(2):238-240. (Case report)
  59. Ahmed I, Shaikh NA. Treatment of intermittent idiopathic priapism with oral terbutaline. Br J Urol. 1997;80(2):341. (Case report)
  60. Burnett AL, Bivalacqua TJ, Champion HC, et al. Feasibility of the use of phosphodiesterase type 5 inhibitors in a pharmacologic prevention program for recurrent priapism. J Sex Med. 2006;3(6):1077-1084. (Retrospective chart review; 7 patients)
  61. Burnett AL, Anele UA, Trueheart IN, et al. Randomized controlled trial of sildenafil for preventing recurrent ischemic priapism in sickle cell disease. Am J Med. 2014;127(7):664-668. (Randomized control trial; 13 patients)
  62. Hoeh MP, Levine LA. Prevention of recurrent ischemic priapism with ketoconazole: evolution of a treatment protocol and patient outcomes. J Sex Med. 2014;11(1):197-204. (Retrospective chart review; 17 patients)
  63. Davila HH, Parker J, Webster JC, et al. Subarachnoid hemorrhage as complication of phenylephrine injection for the treatment of ischemic priapism in a sickle cell disease patient. J Sex Med. 2008;5(4):1025-1028. (Case report)
  64. Mantadakis E, Ewalt DH, Cavender JD, et al. Outpatient penile aspiration and epinephrine irrigation for young patients with sickle cell anemia and prolonged priapism. Blood. 2000;95(1):78-82. (Prospective cohort study; 15 patients, 39 aspiration procedures)
  65. Mulcahy JJ. The development of modern penile implants. Sex Med Rev. 2016;4(2):177-189. (Review)
  66. Martinez Portillo F, Hoang-Boehm J, Weiss J, et al. Methylene blue as a successful treatment alternative for pharmacologically induced priapism. Eur Urol. 2001;39(1):20-23. (Prospec-tive cohort study; 12 patients)
  67. Hubler J, Szanto A, Konyves K. Methylene blue as a means of treatment for priapism caused by intracavernous injection to combat erectile dysfunction. Int Urol Nephrol. 2003;35(4):519-521. (Prospective cohort study; 5 patients )
  68. Park DB, Hayden GE. Ketamine saves the day: priapism in a pediatric psychiatric patient. Pediatr Emerg Care. 2015;31(7):508-510. (Case report)
  69. Govier F, Jonsson E, Kramer-Levien D. Oral terbutaline for the treatment of priapism. J Urol. 1994;151(4):878-879. (Prospective double-blinded randomized control trial; 22 patients)
  70. Lowe F, Jarow J. Placebo-controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin E1-induced prolonged erections. Urology. 1993;42(1):51-53. (Prospective randomized control trial; 75 patients)
  71. Priyadarshi S. Oral terbutaline in the management of pharmacologically induced prolonged erection. Int J Impot Res. 2004;16(5):424-426. (Prospective randomized control trial; 68 patients)
  72. * Enderle J, Jones J. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Bet 1: the effectiveness of oral terbutaline in treatment of priapism. Emerg Med J. 2011;28(6):533-534. (Literature review)
  73. Dai Y, Zhang Y, Phatarpekar P, et al. Adenosine signaling, priapism and novel therapies. J Sex Med. 2009;6 Suppl 3:292- 301. (Literature review)
  74. Kanika ND, Tar M, Tong Y, et al. The mechanism of opiorphin-induced experimental priapism in rats involves activation of the polyamine synthetic pathway. Am J Physiol Cell Physiol. 2009;297(4):C916-C927. (Observational animal study)
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Gregory S. Podolej, MD; Christine Babcock, MD, MSc, FACEP

Publication Date

January 1, 2017

CME Expiration Date

February 2, 2020

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