Commentary on high flow, non-ischemic, priapism

High-flow, non-ischemic priapism is a rare condition,
with which many urologists and andrologists are
unfamiliar. There are three types of high-flow priapism:
traumatic, neurogenic and post-shunting. Traumatic
high-flow priapism may arise from penetrating or blunt
trauma to the penis resulting in rupture of the cavernous
artery or its branches. Despite the unregulated large
arterial flow, this does not result in rigid and painful
erections, as seen in low-flow, ischemic priapism, because
the venous channels are still competent. The neurogenic
type is seen after irritation or injury to the central
nervous system, and this is typically self-limiting. If this
type persists, then it may change to ischemic priapism,
and should be treated accordingly. Post-shunting highflow
priapism is a result of reactive hyperemia in response
to the hypoxic and acidotic state of ischemicpriapism that
lasts more than 24 hours.