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Time critical priorities
Priapism stabilization
Duration 4 hours or more as ischemic until proven otherwise
Urology notification for suspected ischemic priapism
IV access
Cardiac monitor for sympathomimetic therapy
Analgesia plan before corporal procedures
Penile nerve block option for aspiration and injection
Phenotype recognition
Priapism type sorting
Ischemic low flow
Rigid corpora
Significant pain common
Glans often soft
Non ischemic high flow
Partial rigidity
Minimal pain
Trauma history possible
Recurrent stuttering
Repeated self limited episodes
Sickle cell disease association
Immediate complications and escalation
Threats and triggers
Time dependent cavernosal smooth muscle ischemia risk
Hypotension or arrhythmia during phenylephrine
Anticoagulation related bleeding during aspiration
If priapism duration 24 hours or more, early shunt discussion
Hemodynamic and monitoring targets
Monitoring and safety
Continuous ECG during intracavernosal phenylephrine
Blood pressure cycling during injections
Avoid excessive total phenylephrine dosing in cardiovascular disease
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.