Evaluate the knowledge, attitudes, and practices of emergency medicine physicians in managing priapism cases-a cross section study.

Abstract

Introduction: Priapism is an emergency condition treated by emergency medicine (EM) physicians and urologists/andrologists. EM physicians are the first-line healthcare providers for this condition, and their knowledge, attitudes, and practices regarding priapism remain unclear.

Aim: The aim of this study was to understand emergency physicians' perspectives regarding priapism to help re-structure EM programs.

Methods: This cross-sectional study on knowledge, attitude, and practice (KAP) surveyed emergency physicians from a university and other hospitals in the Ismailia governorate, Egypt. A validated questionnaire was sent via an online e-survey following the CHEERIES guidelines. Bivariate analysis of demographic characteristics and KAP was performed using by odds ratios and 95% confidence intervals. Spearman's rho was used to measure the correlation between knowledge, attitude, and practice. A P <0.05 was considered statistically significant.

Main outcome measure: Emergency physicians completed an e-survey of their knowledge, attitudes, and practices regarding priapism.

Results: A total of 149 participants were surveyed. 140 (93%) of EM physicians believed priapism was a medical emergency. 139 (93%) respondents were aware of the long-term complications of priapism. Further, 136 (91.3%) respondents strongly supported the multidisciplinary approach. Of these, 79 (53%) gave intra-cavernous sympathomimetic therapy and 75 (50.3%) did aspiration with irrigation. EM physicians <30 years of age had significantly better knowledge about priapism (OR = 2.47 (1.23-4.96); P = 0.01). Similarly, young physicians had better attitudes (OR = 3.24 (1.31-8.02); P = 0.01) and female physicians demonstrated better practice (OR = 3.36 (1.65-6.82); P = 0.001) toward priapism. A significant positive correlation was observed between knowledge and attitude (r = 0.487), and knowledge and practice (r = 0.281) at P <0.001.

Clinical implications: EM physicians agreed that EM-based therapy is appropriate for straightforward cases of acute ischemic priapism. Existing educational programs for EM physicians may not adequately equip them in handling priapism in practice.

Strengths and limitations: This study is the first to investigate EM knowledge, attitude, and practice (KAP) for priapism handling. The study identified areas for improvement in this regard. However, the cross-sectional design, single governorate setting, and self-administered questionnaire limit its generalizability.

Conclusion: Despite the satisfactory knowledge and attitudes of EM physicians regarding priapism and infection control, this study identified potential areas for improvement in the use of guidelines on invasive treatment.