An unforgettable quote:

Priapism is a persistent penile erection not associated with sexual desire. Low flow or ischaemic priapism is associated with stasis and diminished blood efflux from the cavernous bodies, while high-flow arterial or non-ischaemic priapism is associated with an abnormal increase of blood influx into cavernous bodies. The latter is the result of cavernosal AVF, which causes unregulated and continuous arterial inflow directly into the lacunar spaces, after bypassing the high-resistance helicine arteries. Cavernosal lacunar spaces thus distend in absence of neurological stimulation, but venous outflow is maintained because subtunical venule drainage is not compromised.
Diagnosis of arterial priapism is based on history of trauma, clinical signs, penile blood gas measurement, color-flow Doppler ultrasound, and selective arteriography.
High-flow priapism is usually secondary to cavernosal artery laceration from blunt or penetrating trauma to perineum or penis. In rare cases, the etiology of arterial priapism remains unknown (idiopathic non-ischaemic priapism), as it was in our case.


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