Imran Mushtaq

This study aimed to review the current knowledge on priapism in the paediatric and adolescent population through a review of the current literature. Priapism is defined as a prolonged and persistent penile erection lasting over 4 h, unassociated with a sexual stimulus or persisting after ejaculation and orgasm. It has an incidence of 0.3–1.5 per 100,000 per annum in males of all ages, and comprises 3 main types: ischaemic, non-ischaemic and stuttering. The most common cause of priapism in children is sickle cell disease, and these individuals usually have the ischaemic type of priapism, which is a true urological emergency. We discuss in this article the management pathways for children and young adults, with the main emphasis being on accurate diagnosis and emergent management. Erectile dysfunction is the main consequence of delayed management.

A 2-year-old boy was born with oesophageal atresia and a low anorectal malformation (perineal fistula). There were two urethral orifices: one pinpoint epispadiac and one penoscrotal (figure 1A,B). The corpora cavernosa were hypoplastic and flaccid. He passed urine predominantly through the penoscrotal meatus. His parents noted that his penis ‘grew bigger’ during micturition. Figure 1 (A) The hypospadiac urethral meatus at the penoscrotal junction. (B) The dorsal epispadiac urethral meatus and …