I saw something interesting for the first time today...
We had a 34 y/o male present to the ED with an erection lasting greater than 24 hours, in a great deal of pain (the writhing and sweating kind!).
He had just started taking Trazadone for depression, and priapism can be caused by taking this drug.
First they tried SQ Terbutaline...didn't work. Then they tried Phenylephrine injected into the corpus callosum...also didn't work.
At that point the ER doc called in a urologist who decided he was going to take the pt. to surgery for an irrigation of the corpus callosum. At this point the pt. freaked out and signed out AMA, but he said that his erection was down about 80%. We couldn't convince him to stay and talk to the doc again, so we explained the risks of permanent penile damage, and told him to come back if he started having more pain, and/or if his erection returned. We were all pretty understanding that he was pretty scared of that surgery!
One of the risks of no treatment the urologist told us about was if the blood engorging the penis just sat in there for too long, was the potential for the blood to clot in the penis, cutting off circulation
I just thought that was interesting, so I thought I'd share it, and see if anyone else ever has!