Etiology of priapism

Etiologies of ischemic priapism

Drug induced

Intracavernosal vasoactive injections for erectile dysfunction: Alprostadil, papaverine, phentolamine, prostaglandin E1

Oral prescription medications

Alpha-adrenergic antagonists
Anticoagulants
Antidepressant and antipsychotic medications: Trazodone, SSRIs, bupropion, lithium, risperidone, hydroxyzine
Stimulant/ADHD medications: Atomoxetine

Nonprescription medications/substances

Hematologic

Structural: Sickle cell, thalassemia

Hypercoagulable states: Protein C deficiency and other thrombophilias

Hyperviscosity states: Polycythemia vera, hyperleukocytosis

Etiologies of nonischemic priapism

Perineal trauma that results in laceration of the cavernous artery (needle injection or urologic procedure injury)

Anatomic abnormality: Cavernous arterial fistula, pseudoaneurysm, congenital arterial malformation

Idiopathic

ADHD: attention-deficit/hyperactivity disorder; SSRIs: selective serotonin reuptake inhibitors.

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