Medical treatment of recurrent ischaemic priapism: a review of current molecular therapeutics and a new clinical management paradigm

Objectives To examine the current molecular therapeutics in the medical treatment of recurrent ischemic priapism (RIP). To propose a stepwise clinical management paradigm for the treatment of RIP. Methods We performed a literature search using the PubMed database for the terms 'recurrent ischemic priapism' and 'stuttering priapism' up until December 2020. We assessed pre-clinical and clinical studies regarding medical management of RIP and molecular pathophysiology. Case series and randomized trials were evaluated by study quality and patient outcomes to determine a potential clinical management scheme. Results Recent research has fostered an improved understanding of the underlying molecular pathophysiology of RIP that has paved the way forward for developing new therapeutic agents. Medications targeting neurovascular, hormonal and haematological mechanisms associated with RIP show great promise towards remedying this condition. A host of therapeutic agents operating across different mechanistic directions may be implemented according to a clinical management scheme to potentially optimize RIP outcomes. Conclusion RIP remains a medically neglected condition with current management focused on treating the acute condition rather than modulating the course of disease. Continued research into the molecular mechanisms of RIP and standardized clinical pathways can improve the quality of care for patients suffering from this condition.

Automated summary

Recent research has enhanced the understanding of the molecular pathophysiology underlying RIP and paved the way for new therapeutic agents. Medications targeting neurovascular, hormonal, and hematological mechanisms associated with RIP show promise in addressing the condition. A variety of therapeutic agents acting in different mechanistic directions can be implemented according to a clinical management scheme to potentially optimize outcomes for RIP.