Priapism — an abnormal prolonged penile erection that persists in the absence of any sexual stimulation — can be subcategorized into three types: ischaemic (low-flow or veno-occlusive), non-ischaemic (high-flow or arterial) and stuttering, also known as recurrent ischaemic, priapism. The mechanisms underlying stuttering priapism are complex and involve dysregulation of the nitric oxide signalling pathway, Rho–Rho kinase pathway, adenosine, opiorphins, oxidative stress and androgens, and treatment can target these pathways, or be surgical in approach. In this Review, the authors discuss the pathology of the different types of priapism and provide an update on the different therapeutic options available.
- Karl H. Pang
- Hussain M. Alnajjar
- Asif Muneer