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Guideline of guidelines: priapism

Asif Muneer*,† and David, Ralph‡,§
*Departments of Urology, †National Institute for Health Research (NIHR) Biomedical Research Centre, ‡Departments of
Andrology, University College London Hospitals, and §St Peters Andrology Centre, London, UK

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.
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