What Is Priapism?

Priapism is defined as a persistent penile erection that lasts for longer than 4 hours that is not related to sexual activity. This can result in tissues of the penis becoming hypoxic, or not receiving enough oxygen to the tissues. If you delay this for over 24 hours, you can get irreversible erectile dysfunction and fibrosis or scarring of the penile tissue.

Causes of Priapism

Priapism is caused by taking medications for erectile dysfunction however there are other causes some of these include

• Sickle-Cell Disease: Some studies say that 42% of men with sickle cell disease will get Priapism at some point.
• Cancer:  cancers like leukemia can have a malignant infiltration of the penis.
• Nutrition: sometimes, receiving nutrients through an IV like TPN can cause this problem.
• Medications: Priapism is caused by taking medicines for erectile dysfunction. Certain medications such as (Depression Treatment) Trazodone are known to cause it.
• Drugs: Using street drugs like marijuana and cocaine

Also, sometimes very rare IV contrast can cause Priapism.

How is it done?

There are two main types of Priapism. Ischemic and non-ischemic priapism.

Ischemic Priapism:

Ischemic Priapism is also called low flow priapism. It’s the most common type of Priapism.

Symptoms:

• Any erection lasting more than four hours or unrelated to sexual interest or stimulation
• Extreme Pain in the penis
• Rigidity of the penis

Recurrent or Stuttering Priapism is a form of ischemic Priapism. When you have an erection related to Priapism that goes through detumescence, it becomes flaccid and then has recurring Priapism lasting for longer than four hours.

Treatment:

Treatment for ischemic Priapism beings with a penile block, to numb the penis. After you numb the area, you inject both sides of the penile shaft with a needle and pull out the blood from the penis itself, that’s called corporal aspiration.  Sometimes you can irrigate fluid into it to help clear out that blood, and that typically resolves the Priapism in most cases. If that doesn’t work, surgery may be required to create a shunt in the erectile tissue of the penis to allow detumescence or reduction of the erection.

Non-Ischemic Priapism:

Non-Ischemic Priapism is also known as high flow priapism.

Symptoms:

• An erection lasting more than four hours or unrelated to sexual interest or stimulation
• Less painful than Ischemic
• Partially erect penis

Treatment:

Non-ischemic Priapism often goes away without treatment. Your doctor may suggest a watch-and-wait approach because there isn’t a risk of long-term damage to the penis. Ice packs and pressure on the groin and perineum region can be helpful.