What is Priapism?
Priapism is a prolonged and often painful erection of the penis that lasts for more than four hours and occurs without sexual stimulation. It is a medical emergency that requires prompt treatment to prevent permanent damage.
What causes Priapism?
Causes of priapism include:
- Blood disorders such as sickle cell anemia and leukemia
- Use of certain medications, including erectile dysfunction drugs, antidepressants, and blood thinners
- Injury or trauma to the genital area or spinal cord
- Alcohol or drug abuse
- Neurological conditions
- Idiopathic causes (unknown reasons)
What are the symptoms?
- A persistent, often painful erection lasting more than four hours
- Erection not related to sexual arousal or stimulation
- Swelling and tenderness of the penis
- Possible urinary retention due to discomfort
How is Priapism diagnosed?
Diagnosis involves:
- Medical history and physical examination
- Evaluation of blood flow in the penis using Doppler ultrasound
- Blood tests to check for underlying conditions like sickle cell disease or infection
- Urinalysis and other tests as needed
How is Priapism treated?
Treatment depends on the type and cause:
- Ischemic (low-flow) priapism: Immediate treatment is critical to restore normal blood flow. Methods include aspiration of blood from the penis, injection of medications to constrict blood vessels, and sometimes surgery.
- Non-ischemic (high-flow) priapism: Often less painful and may resolve on its own, but may require arterial embolization or surgery if persistent.
- Addressing underlying causes such as sickle cell crisis or medication side effects
What is the prognosis?
With timely treatment, most cases can be resolved without permanent damage. Delayed treatment increases the risk of erectile dysfunction and tissue damage.
What complications can occur?
- Permanent erectile dysfunction
- Tissue scarring and fibrosis
- Penile deformity
- Psychological distress due to pain and sexual dysfunction
Who is most at risk?
- Males with sickle cell anemia or other blood disorders
- Men using medications for erectile dysfunction
- Individuals with genital or spinal injuries
- Those who abuse drugs or alcohol
Can Priapism be prevented?
Prevention strategies include:
- Managing underlying medical conditions properly
- Avoiding recreational drugs and careful use of medications
- Seeking prompt medical care if an erection lasts longer than 4 hours
Are there support resources?
Yes, support includes:
- Urologists specializing in sexual health
- Counseling and psychological support for coping with the condition
- Patient education on medication use and recognizing symptoms early