Ischemic priapism, the most prevalent subtype, constitutes over 95% of all priapism cases, with an estimated annual incidence of 5.34 per 100,000 men in the United States. Characterized by impaired venous outflow and reduced cavernosal blood flow, it is commonly confirmed through cavernous blood gas (CBG) analysis. Notably, ischemic priapism occurs in approximately 33% of men with sickle cell disease (SCD). Standard pharmacological management includes penile aspiration combined with intracavernosal injection (ICI) of sympathomimetic agents such as phenylephrine and etilefrine. These therapies encounter several challenges, including ineffectiveness, off-target effects, and possible complications such as pain, penile fibrosis, and deformities. This highlights the need for novel treatment options. Although pharmacological treatments and surgical procedures are available, there is still a significant demand for novel therapies due to the complexities associated with ischemic priapism and its underlying pathophysiology. This review aims to evaluate the potential of novel therapies as modalities for managing ischemic priapism. By utilizing various treatment modalities, it is possible to achieve localized and targeted action, enhanced safety, minimal off-target effects, and improved patient compliance. Furthermore, this review will explore the potential integration of new drug delivery systems for the management of ischemic priapism.
Tiwary et al. (Mon,) studied this question.