Liên tục cương cứng của dương vật nhiều hơn 4 giờ mà không liên quan hoặc kèm theo ham muốn tình dục. Có hai loại chính: thiếu máu cục bộ (veno occlusive, thấp dòng chảy), và nonischaemic (động mạch, cao dòng chảy). Nó có thể ảnh hưởng đến bất kỳ độ tuổi, nhưng hai nhóm tuổi bị ảnh hưởng là 5 - cậu bé 10 tuổi và 20 người đàn ông 50 tuổi | 132 J. REYNARD AND H. HASHIM we take a swab and send it for culture. We fix the testis and the contralateral testis as a prophylactic measure. PRIAPISM Definition Persistent erection of the penis for more than 4 hours that is not related or accompanied by sexual desire. There are two main types ischaemic veno-occlusive low flow and nonischaemic arterial high flow . It can affect any age but the two main age groups affected are 5- to 10-year-old boys and 20- to 50-year-old men. There is a third type of priapism called stuttering priapism which is an intermittent recurrent form of ischaemic priapism. History Ask the patient about these four main points Duration of erection 4 hours Is it painful or not Pain implies ischaemia due to low flow absence of pain implies high flow priapism with no ischaemia. Previous history and treatment of priapism Identify any predisposing factors Causes Idiopathic drugs Antihypertensives Anticoagulants . heparin warfarin Antidepressants . paroxetine fluoxetine Alcohol Recreational drugs . Marijuana cocaine Intracavernous injections of vasoactive drugs . alprostadil papaverine Trauma Pelvic Genital Perineal . straddle injury Neurological Seizure Cerebrovascular accident Lumbar disc disease Spinal cord injury Haematological disease Sickle cell disease Thalassaemia Thrombophilia Leukaemia Myeloma 6. SCROTAL AND GENITAL EMERGENCIES 133 Tumours Bladder cancer Prostate cancer Metastatic renal cancer Miscellaneous Amyloid Carbon monoxide poisoning Total parenteral nutrition Rabies Black widow spider bites Malaria Fabry s disease Examination Look for the following Rigid corpora cavernosa The corpus spongiosum and glans penis are usually flaccid. Investigations Full blood count white cell count and differential reticulocyte count Haemoglobin electrophoresis for sickle cell test Urinalysis including urine toxicology Blood gases taken from either corpora using a blood gas syringe to aspirate blood will help in differentiating between
