Sexual Medicine Reviews: The Premier Review Journal for the Field of Sexual Medicine

The management of recurrent ischemic priapism (RIP) was not clearly defined, with most treatment options supported by low-level evidence. The article reviewed the pathophysiology and management of RIP, discussing various treatment options such as ketoconazole, 5‐α‐reductase inhibitors, PDE5 inhibitors, and intracavernosal sympathomimetic injections. While some agents like ketoconazole and finasteride showed effectiveness, they also had significant hormonal side effects. PDE5 inhibitors were well tolerated, but their efficacy was limited. Intracavernosal α‐agonist therapy was used for treating episodes after they occurred. Limited data suggested other agents like terbutaline and gabapentin might be useful. An ideal strategy would focus on prevention with an effective, well-tolerated, and cost-effective medication. Despite advancements, further research and clinical studies were needed to improve management of RIP.