How I treat priapism. For episodes lasting greater than 4 hours, urgent urologic consultation for prompt aspiration +/- sympathomimetic injection is recommended. For stuttering episodes, it is reasonable to attempt increased hydration and pain management. Long-term oral sympathomimetics may be beneficial in the prevention of recurrent episodes, as well as therapy with hydroxyurea (HU) or chronic transfusions. Hu, hydroxyurea; IV, intravenous.