High-flow priapism: waiting for 3 months?

[outilleur]

Dear Doctor,

My son, age 22, received a blunt trauma to the perineum during a bicycle accident.  The priapism did not show up immediately, but rather gradually appeared over the course of approximately 10 days following the accident.  He finally went to a GP, who referred him immediately to a urologist.  He had a blood oxygen pH test, and that was normal.  He had a colour Doppler of the penis, and no fistula could be found.  The next step would be a fluoroscopic x-ray of the perineal area, but the urologist (actually 2 urologists - a locum was in the office as well), said that they did not think that this would reveal anything in this circumstance.  They felt that a wait and see approach was best, and were confident that it would resolve within 3 months.  Does this make sense to you?

Also, should my son be treating the perineum with ice or anything else?  

I assume that he should not be exposing himself to any unnecessary risks (bikes, etc.) during this period.

He is uncomfortable physically and cannot sleep well.  He is "distracted" all the time by it.  He is demoralized emotionally.

Any thoughts you have would be greatly appreciated.

Thank you.

[outilleur]

To Jasonharold regarding high-flow priapism.

Thank you for your comments.  Please note that high-flow priapism is not the same as low-flow priapism, which is a medical emergency.  They cannot find a fistua from the Doppler, and the oxygen and pH is normal.  

However, I totally agree with you about a second opinion - I wish I had thought of that when I went down to the city where my son is attending school.  I have just written him, strongly encouraging him to get a second opinion ASAP, which is definitely a must.

Thanks very much.

[jasonharold]

I warn do not wait! Get another opinion priapism can cause serious damage and every second is crucial. Waiting is like watching a person drown. Action must be taken!