Table 2.
Differences between ischemic and nonischemic priapism
| Characteristic | Ischemic | Nonischemic |
|---|---|---|
| Pain | A common feature | Not a common feature |
| Erection hardness | Rigid with the soft glans penis | Not rigid |
| Trauma | No associated history of penile trauma | Trauma or penile surgical procedure is a common feature |
| Medical conditions and drugs | Commonly associated with SCD, other hematologic disorders, snake and scorpion venoms, alcohol, recreational drugs, or medications | Not associated with any medical condition, except as a complication of penile surgical interventions |
| Pattern | Recurrent | Not recurrent |
| Blood aspirate color | Dark | Bright red |
| Blood gas analysis | PO2 <30 mm Hg, PCO2 >60 mm Hg, pH <7.25 | PO2 >90 mm Hg, PCO2 <40 mm Hg, pH 7.4 |
| Ultrasound color Doppler scan | Low arterial flow Fibrosis can be identified |
High arterial flow No fibrosis |
| Acute treatment strategies | Supportive care, corporal aspiration, and surgical shunt | Conservative management, arterial embolization, and surgical ligation |
| Secondary prevention | Needed in recurrent events | Not required |
| Penile implantation | May be required when associated with erectile dysfunction | Unlikely to be required. |
PCO2, partial pressure of carbon-dioxide; PO2, partial pressure of oxygen.