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Volume 14, Issue 1 (January 2012) 14, 156–163; 10.1038/aja.2011.114

Medical management of ischemic stuttering priapism: a contemporary review of the literature

Helen R Levey1, Omer Kutlu2 and Trinity J Bivalacqua2

1 The Arthur Smith Institute for Urology, North Shore - Long Island Jewish Health System, New Hyde Park, NY 11010, USA
2 The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins Hospital, Baltimore, MD 21287, USA

Correspondence: Dr HR Levey, (Helen.Levey@gmail.com)

Received 22 April 2011; Revised 10 June 2011; Accepted 15 June 2011; Published online 7 November 2011


Priapism is defined as a prolonged and persistent erection of the penis without sexual stimulation. This is a poorly understood disease process with little information on the pathophysiology of this erectile disorder. Complications from this disorder are devastating due to the irreversible erectile damage and resultant erectile dysfunction (ED). Stuttering priapism, though relatively rare, affects a high prevalence of men with sickle-cell disease (SCD) and presents a challenging problem with guidelines for treatment lacking or resulting in permanent ED. The mechanisms involved in the development of priapism in this cohort are poorly characterized; therefore, medical management of priapism represents a therapeutic challenge to urologists. Additional research is warranted, so we can effectively target treatments for these patients with prevention as the goal. This review gives an introduction to stuttering priapism and its clinical significance, specifically with regards to the patient with SCD. Additionally, the proposed mechanisms behind its pathophysiology and a summary of the current and future targets for medical management are discussed.

Keywords: erectile dysfunction; ischemic priapism; medical management; recurrent priapism; sickle cell disease; stuttering priapism; therapy; treatment

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