[Priapism: decisional algorithm, our experience, and role of sildenafil in sexual rehabilitation]

We report our experience in the management of priapism.In a 2-year period we observed 7 patients of whom 4 presented with low flow and 3 with high flow priapism.In 2 of the patients with ischemic priapism, simple blood aspiration from the corpora allowed for a quick detumescence, while in the other 2 cases a derivative intervention (1 spongio cavernous and 1 glans cavernous) had to be performed. In all the 3 patients with high flow priapism we performed a superselective arteriography that obtained the visualisation of the arteriovenous fistula. These patients restarted their sexual activity after about three months. At six months a patient with low flow priapism restored sexual activity due to sildenafil 50 mg.The importance of distinguishing low and high flow priapism was confirmed.