The objective of the study was to conduct a retrospective audit of patients who presented with
priapism in Western Australia during the years 1985-2000. We searched the records of the teaching hospitals in metropolitan Perth and those of the Keogh Institute for Medical Research for the diagnostic code for
priapism. A total of 82 episodes of
priapism in 63 patients occurred over this 16 year period. In all, 62 episodes occurred after intracavernosal
injections (ICI) and 20 were due to other causes. Treatment of
priapism included simple aspiration of blood, intracavernosal injection of alpha-
adrenergic agents and surgical shunt procedures.
Priapism occurring outside the setting of ICI was more likely to require surgery; seven of 20 episodes. After ICI
therapy, eight of 62 episodes required shunts. The use of
prostaglandin E1 as the
drug of choice in ICI
therapy in 1989 led to a fall in the incidence of ICI-induced
priapism.
Priapism is a major side effect of ICI
therapy and an uncommon, although important, side effect of other conditions. The incidence of
priapism has fallen with the introduction of
prostaglandin E1 monotherapy as the favoured
drug for ICI
therapy of erectile failure.