Which statement accurately describes ischemic priapism?

• A. Ischemic (low-flow) priapism is due to decreased venous outflow
• B. Nonischemic (high-flow) priapism is due to decreased arterial inflow
• C. Ischemic priapism is not a medical emergency
• D. Ischemic priapism is typically caused by penile infections

Answer: (A)

Ischemic priapism is a low-flow state in which the problem is failure of venous outflow from the corpora cavernosa, causing blood to become trapped and deoxygenated. This stasis leads to hypoxia and acidosis, intense penile pain, and a rigid erection. Because the penile tissue can suffer irreversible damage with prolonged ischemia, this is a medical emergency requiring urgent intervention to restore outflow and oxygen delivery. In contrast, high-flow (nonischemic) priapism results from unregulated arterial inflow—usually after trauma with an arteriovenous fistula—and tends to be less painful and not an immediate emergency. Penile infections are not a typical cause of ischemic priapism.