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Priapism – The Erection You Don’t Want

What is Priapism?
A sustained, an often painful, erection that lasts for over four hours is a condition known as priapism. The penis will remain erect even when all forms of sexual stimulation have been removed. There are, essentially, two forms of the condition:

  • low-flow priapism: this results from blood being trapped in the erection chambers which cannot fully returning to the body from the penis
  • high-flow priapism: an injury to the penis artery prevents proper circulation and the result is too much blood flowing into the organ; this blood vessel rupture can also occur in the perineum (the area between the anus and the testicles).

High-flow priapism is the less-common form of the condition (around 20% of cases) and often less painful. Either form will, however, affect men of all ages and may lead to disfiguring of the penis or more permanent erectile dysfunction.

What are the causes of Priapism?

There are a number of possible causes to this medical condition and include:

  • Blood disorders: it’s understood more than 40% of sickle-cell anemia sufferers will develop priapism at some stage; leukemia victims are also prone.
  • Medicines: men taking long-term drug treatments for depression and mental illness are susceptible to the condition.
  • casual drug use: both cocaine and marijuana have been linked to priapism.
  • Poisonous venom: from spider or scorpion bites.
  • Injury: to either the spinal cord or genitalia.

Any lengthy, sustained erection occurring without sexual or drug stimulation should be taken seriously and medical advice should be sought immediately. In order to determine the likely cause, a doctor will typically check on a patient’s medical history, any trauma that may have occurred locally to the penis and if any medication or drugs are involved. Blood tests, oxygenation levels and ultrasounds are typical procedures in determining what form of priapism may be present.

It’s worth noting that the longer the delay in seeking professional advice, the greater the chance of permanent erectile damage.

What are the current priapism treatments?

Treatments for priapism can be divided into two categories: the first is aimed at achieving blood transfer for immediate relief while the second offers more long-term solutions.

Immediate treatments:

  • Ice: applying an ice pack to the penis and surrounding areas may help reduce the swelling
  • Aspiration: Using a local anesthetic, a doctor insert a needle into the penis to release excess blood to relieve pressure and pain.
  • Medication: taking oral drugs, such as alpha-agonists, has the effect of constricting vessels taking blood into the penis which in turn allows venous blood to flow back to the body; for a more effective result this treatment can be administered by an injection into the spongy tissue of the organ.

Longer term treatments:

  • Artery ligation: in some high-flow conditions, a surgeon can tie off the ruptured artery and thereby restore normal blood circulation into the organ.
  • Surgical shunt: for low-flow priapism, a tube known as a shunt can be inserted into the penis surgically which diverts the blood flow and corrects circulation.

What steps can be taken to prevent Priapism?

If another disease is present and the cause of priapism, then, of course, that needs treatment. Triggers, such as alcohol and illegal drugs, should be avoided and any prescription medicine that might be responsible for the condition should be changed. Hormone treatment and prescription muscle relaxants, such as baclofen, may have positive benefits in keeping the symptoms of priapism at bay.

Priapism can be a debilitating condition but if medical support is taken early enough the treatments available can offer an effective solution to the problem.