Priapism is defined as a prolonged penile erection lasting for >4 h in the absence of sexual stimulation and remains despite orgasm. Current guidelines for priapism have been published after a comprehensive literature review and expert consensus by the AUA and by an evidence review according to the Oxford Centre for Evidence-Based Medicine (OCEBM) by the European Association of Urology (EAU). Although there are both local and regional guidelines available throughout the UK, these tend to be adaptations of guidelines from larger urology organisations and there are currently no guidelines available from the BAUS. However, in the UK the management of complex cases is increasingly undertaken in specialist centres with the basic management following existing guidelines.
As priapism is a urological emergency, which requires immediate detumescence, the condition does not lend itself to randomised controlled trials and the EAU guidelines are based, at best, on Level 3 evidence.