Some patients with priapism may develop erectile dysfunction. Certain risk factors can identify those patients who may benefit from more aggressive therapy and closer monitoring.
The mechanism of the erectile dysfunction appears related to cavernosal tissue fibrosis, which results in a loss of distensibility of the cavernosal sinusoids and an inability to engorge. Patients eventually develop incompetent veno-occlusion.
(2) failure to achieve complete detumescence with therapy
(3) development marked penile fibrosis
On multivariate analysis only prolonged erection remained significant.
Differential diagnosis: Ischemic priapism may follow oral or injection therapy for erectile dysfunction. This group needs to be distinguished from those without a prior history of erectile dysfunction.
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