Priapism Diagnosis: Understanding Evaluation & Testing

Diagnosis is clinical and the goal of diagnostic testing is to determine an etiology.

- Physical Examination: Determine if priapism is ischemic or non-ischemic. Check for penile pain and temperature, and corpus spongiosum distension.

- Arterial Blood Gas: Low oxygen tension and high Pco2 and pH values confirm ischemic priapism.

- Penile Duplex Doppler ultrasonography: Can distinguish ischemic from non-ischemic priapism. In ischemic priapism, there is absent flow in the cavernosal arteries.

- Cavernosography and dynamic infusion cavernosometry: Performed in patients with recurrent priapism to assess corporal anatomy, cavernosal pressures and flow rates, and may identify leaks.