Pelvic vascular thrombosis is most often incriminated. The corpora cavernosa, rarely thrombosed completely, usually contain thick, dark venous blood of motor-oil consistency. The corpus spongiosum and glans penis are not involved. Prognosis and Treatment Prognosis for recovery of sexual function is poor unless treatment is prompt and effective. In general, treatment is difficult and sometimes unsuccessful.
Estrogens are ineffective.
Neurogenic priapism may be alleviated by continuous caudal or spinal anesthesia. Creation of a fistula between the glans and corpus cavernosum with a biopsy needle has been successful. Semipermanent diversion by means of a saphenous vein shunt from one or both corpora or a cavernosa-spongiosum shunt may result in detumescence of sufficient duration to permit reestablishment of pelvic circulation. Underlying causes should be treated, such as medical therapy for sickle cell disease, which may be effective in resolving priapism. The cause is unknown.