Medical Treatment of Recurrent Ischemic Priapism: A Review of Current Molecular Therapeutics and New Clinical Management Paradigm.

Priapism is a medically neglected disorder for which traditional treatment is primarily aimed at resolving its acute phase. Patients with priapism recurrences, termed recurrent ischemic priapism (RIP), are commonly subjected to frequent ER visits and invasive procedures without significant improvement in the course of their condition. Many eventually undergo radical, circumventive treatments including androgen withdrawal and IPP placement, which preclude natural sexual function. Recent research has fostered an improved understanding of the underlying molecular pathophysiology of RIP that has paved the way forward for developing new therapeutic agents. Medications targeting neurovascular, hormonal, and hematologic mechanisms associated with RIP show great promise towards remedying this condition. A host of therapeutic agents operating across different mechanistic directions may be implemented according to a clinical management scheme to potentially optimize RIP outcomes.