Surg: Priapism: Free MSRA Podcast

🍆 Priapism: Painful, Prolonged & Urgent 🛑Welcome to today’s deep dive! We’re making priapism memorable: what it is, why it matters, and how to ace it for your MSRA or finals.Prolonged erection >4 hoursNot related to sexual desireUsually painfulTwo types: - Ischaemic (low-flow) – 🚦“Traffic jam” (emergency!) - Non-ischaemic (high-flow) – 🚿“Stuck tap” (less urgent)Sickle cell disease (most common in kids)Haematological malignancy (leukaemia, myeloma)Meds: Erectile dysfunction drugs (PDE5 inhibitors), antipsychotics, anticoagulantsTrauma (especially non-ischaemic)Recreational drugs (esp. cocaine)Idiopathic (unknown) in many casesMnemonic: “SICK Trauma Meds”Ischaemic: Painful, fully rigid, dark blood, EMERGENCYNon-ischaemic: Painless, partially rigid, post-trauma⚠️ Both: Erection >4 hoursAssociated: Anxiety, tenderness, possible swellingHistory & exam – always firstCavernosal blood gas: - Ischaemic: Low O₂, low pH, high CO₂ (stagnant, deoxygenated) - Non-ischaemic: Normal/arterial gasDoppler ultrasound – assess flowBloods: FBC, sickle cell screen, tox screenIschaemic = EMERGENCY! 1. Aspiration (drain trapped blood) 2. Intracavernosal phenylephrine 3. Surgery/shunt if unresolvedNon-ischaemic: - Often just observe/wait - Embolisation for persistent casesErectile dysfunction (ED)Fibrosis/penile scarring, curvatureRecurrenceInfection/bleeding (from treatment)Psychological impactIschaemic: Outflow blocked, oxygen lowNon-ischaemic: Inflow high, no O₂ low (initially)1️⃣ Sickle cell, 5h painful erection, low O₂/pH: - Diagnosis? Ischaemic priapism - First line treatment? Aspiration2️⃣ Non-painful, after trauma, partial erection: - Management? ObservationRevision Notes:https://www.passthemsra.com/topic/priapism-revision-notes/Flashcards:https://www.passthemsra.com/topic/priapism-flashcards/Accordion Q&A:https://www.passthemsra.com/topic/priapism-accordion-qa-notes/Rapid Quiz:https://www.passthemsra.com/topic/priapism-rapid-quiz/Full Quiz:https://www.passthemsra.com/quizzes/priapism/More resources:https://www.passthemsra.comhttps://www.freemsra.com>4h erection = medical reviewIschaemic? Treat NOW to prevent ED!Non-ischaemic? Usually observeCauses: sickle cell, trauma, meds, drugsKnow your management steps & complications#Priapism #MSRA #Urology #SickleCell #MedicalRevision #PassTheMSRA #FreeMSRA #GPExamPrep #EmergencyMedicine 🍆🛑🧪⚡️ What is Priapism?🔑 Causes & Risks👀 Clinical Features🩸 Diagnosis💊 Management🚩 Complications🧠 Revision Mnemonics🔥 Sample Questions📚 MSRA Quick Links🌟 Key Takeaways