Evaluating the Management Trends for Priapism and Assessing the Risk of Priapism After In-office Intracavernosal Injections

Abstract We aim to describe the management trends of patients suffering from any priapism, and to evaluate the risks of developing priapism after intracavernosal injections (ICI) performed in the office. We queried TriNetX for two separate male adult cohorts - those who presented with any priapism based on ICD code, N48.3 and those who underwent ICI in the office based on CPT code, 54235. We evaluated treatment options for these patients after any priapism and described demographic risks for developing priapism after ICI performed in office. There were 17,545 priapism encounters and 26,104 usages of ICI in the office. Most common treatment for any priapism was corporal irrigation/injection of medications. The prevalence of prosthesis implants for the acute management of any priapism was low (0.33% malleable, 0.18% inflatable). Patients presenting with priapism after ICI were younger and had a disproportionate prevalence of mood disorders, pain disorders and sickle cell disease. They were less likely to have diabetes, hypertension, prostate cancer or have taken sildenafil or tadalafil. Despite increased exposure, the utility of penile prosthesis placement after priapism remains low. For patients administered and prescribed ICI, proper screening and counseling of developing priapism is important to reduce complications such as erectile dysfunction.