Abstract
Objective
We review the English literature between 1980 and 2013 and summarize the clinical
classification, aetiology, physiology, and pathophysiology of paediatric priapism.
We propose a clinical guideline for the management of priapism in children.
Patients
Male patients aged ≤18 years.
Results
Priapism, a prolonged penile erection lasting >4 h, is a rare condition in childhood.
There are 3 widely accepted types of priapism: 1) ischaemic priapism, the commonest
type seen in children; 2) stuttering priapism, recurrent, self-limiting prolonged
erections; and 3) non-ischaemic priapism, rare in children, usually due to trauma.
Neonatal priapism has also been described.
Ischaemic priapism is a urological emergency causing fibrosis of the corpora cavernosa,
subsequent erectile dysfunction and penile disfigurement. The commonest causes of
priapism in children are sickle cell disease (65%), leukaemia (10%), trauma (10%),
idiopathic (10%), and pharmacologically induced (5%).
Conclusions
Priapism in children must be assessed urgently. Rapid resolution of ischaemic priapism
prevents permanent cavernosal structural damage and is associated with improved prognosis
for potency later in life. Stuttering priapism requires careful counselling for episodic
management. Chronic prophylaxis may be obtained using α-adrenergic sympathomimetics,
phosphodiesterase type 5 inhibitors and, in sickle cell disease, hydroxyurea. Non-ischaemic
and neonatal priapism may generally be treated less urgently.
Keywords
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Article Info
Publication History
Published online: October 16, 2013
Accepted:
July 30,
2013
Received:
May 8,
2013
Identification
Copyright
© 2013 Journal of Pediatric Urology Company. Published by Elsevier Inc. All rights reserved.
