Mulloy E, Li S, Belladelli F, Del Giudice F, Glover F, Eisenberg ML. The risk of cardiovascular and cerebrovascular disease in men with a history of priapism. J Urol. 2023;209(1):253-260.

Study Need and Importance

Priapism is a debilitating, often idiopathic condition that may be related to undiagnosed coagulopathy or vascular dysfunction in some cases. While the urological manifestations following priapism are well known, less is known about whether priapism may be a harbinger for future vascular or thromboembolic events. This would emphasize the need for continued follow-up of men with priapism beyond their acute priapism event.

What We Found

Our study compared 10,459 healthy men with priapism to men with other urological genital ailments (ie, 10,438 men with erectile dysfunction, 8,549 men with Peyronie’s disease, and 7,971 men with premature ejaculation). We determined incident cardiovascular and thromboembolic disease in the years following a priapism episode. Men with priapism had a 24% higher risk of ischemic heart disease, 31% higher risk of cerebrovascular disease, and 15% higher risk of arterial disease compared to men with erectile dysfunction in the years following their priapism episode. Similar findings were noted comparing priapism men to Peyronie’s disease and premature ejaculation controls. Additionally, men with recurrent priapism episodes showed increasingly higher rates of vascular diseases.

Limitations

All men in the study were commercially insured and the definitive etiology of priapism was not available, which are limitations of the study.

Interpretation for Patient Care

Men with priapism demonstrated higher incidence of cardiovascular and cerebrovascular diseases. Thus, priapism may be an indicator of a broader underlying cardiovascular or coagulopathic condition in some patients. These patients may benefit from additional adjuvant testing and monitoring after the priapism event that extend beyond that of sexual health.