No AccessJournal of UrologyAdult Urology1 Oct 2013

Incidence of Priapism in Emergency Departments in the United States

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    Priapism is a complex medical emergency that often requires prompt management. In this study, we examine the incidence of this condition in a United States population based setting, and assess patient and emergency department attributes associated with an increased likelihood of hospitalization.

    Materials and Methods:

    Emergency department visits with a primary diagnosis of priapism between 2006 and 2009 were abstracted from the Nationwide Emergency Department Sample. Univariable and multivariable analyses were performed of patient and hospital characteristics of those admitted with priapism.


    Between 2006 and 2009 a weighted estimate of 32,462 visits to the emergency department for priapism was recorded in the United States, which represents a national incidence of 5.34 per 100,000 male subjects per year. The incidence of emergency department visits increased by 31.4% during the summer compared to the winter months. Overall 4,320 visits (13.3%) resulted in hospitalization/admission for further management. On multivariable analyses independent predictors of admission included Charlson comorbidity index score 3 or greater (OR 5.67, p <0.001), insurance status (Medicaid vs private OR 1.60, p = 0.001), hospital location (rural vs urban nonteaching OR 0.32, p <0.001), median ZIP code income (very high OR 0.65, p = 0.005), emergency department volume (very high vs very low OR 1.61, p = 0.004), sickle cell disease (OR 2.22, p <0.001) and drug abuse (OR 5.47, p <0.001).


    Emergency department visits for priapism are relatively uncommon and occur more frequently during the summer months. The majority of patients are treated and released expediently. Predictors of hospital admission included comorbidity profile, insurance, hospital location and emergency department volume.


    • 1 : Priapism: pathogenesis, epidemiology, and management. J Sex Med2010; 7: 476. Google Scholar
    • 2 : Priapism: new concepts in medical and surgical management. Urol Clin North Am2011; 38: 185. Google Scholar
    • 3 : American Urological Association guideline on the management of priapism. J Urol2003; 170: 1318. LinkGoogle Scholar
    • 4 : Acute management of priapism in men. BJU Int2012; 109: 15. Google Scholar
    • 5 : The aetiology, pathogenesis and management of priapism. BJU Int2002; 90: 149. Google Scholar
    • 6 : Surgical management of ischemic priapism. J Sex Med2012; 9: 114. Google Scholar
    • 7 : Priapism: evolution of management in 48 patients in a 22-year series. J Urol1977; 117: 455. LinkGoogle Scholar
    • 8 : Priapism, its incidence and seasonal distribution in Finland. Scand J Urol Nephrol1995; 29: 93. Google Scholar
    • 9 : The incidence and management of priapism in Western Australia: a 16 year audit. Int J Impot Res2003; 15: 272. Google Scholar
    • 10 : Incidence of priapism in the general population. Urology2001; 57: 970. Google Scholar
    • 11 : The rationale for prostaglandin E1 in erectile failure: a survey of worldwide experience. J Urol1996; 155: 802. LinkGoogle Scholar
    • 12 : Priapism in the United States: the changing role of sickle cell disease. Am J Surg2011; 201: 468. Google Scholar
    • 13 : Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol1992; 45: 613. Google Scholar
    • 14 United States Census Bureau, 2000 (cited 2010). Available at Accessed January 3, 2013. Google Scholar
    • 15 : Temporal trends, practice patterns, and treatment outcomes for infected upper urinary tract stones in the United States. Eur Urol2013; 64: 85. Google Scholar
    • 16 : Chapter 1: The management of erectile dysfunction: an AUA update. J Urol2005; 174: 230. LinkGoogle Scholar
    • 17 : Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol2010; 57: 804. Google Scholar
    • 18 : Haemoglobinopathies in Australia. Med J Aust1972; 2: 726. Google Scholar
    • 19 : Population estimates of sickle cell disease in the U.S. Am J Prev Med, suppl.2010; 38: S512. Google Scholar
    • 20 : The number of people with sickle-cell disease in the United States: national and state estimates. Am J Hematol2010; 85: 77. Google Scholar
    • 21 : Current and future strategies for preventing and managing erectile dysfunction following radical prostatectomy. Eur Urol2004; 45: 123. Google Scholar