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Priapism is a state of prolonged erection of the penis that can last for more than four hours and is extremely painful. It doesn’t occur from natural sexual stimulation and therefore, needs medical diagnosis.

Symptoms of priapism

There are 3 types of priapism and the symptoms differ accordingly.

Ischemic or low flow- blood gets trapped in the penis. The symptoms are pain and tenderness in the penis, erection that is either interment or continuous but lasts for more than four hours

Non ischemic or high flow- It’s painless but blood flows vociferously in the penis may be due to a ruptured artery. The erection although is prolonged but is less rigid than ischemic type.

Suttering priapism- The erection occurs repeatedly but is transient in nature.

Causes of Priapism

It’s more common in boys between age group of 5-10 and in men of 20-50 years.

  • Blood related diseases like sickle cell anaemia, leukaemia, malaria
  • Trauma or injury to genitals, pelvis, rectal area, spinal cord, etc.
  • History of cancer, tumor and pelvic disease
  • Side effects of drugs like anti depressants, psychotic medicines, antidepressants, blood thinners and sexual drugs.
  • Addiction to recreational drugs like cocaine, marijuana and alcohol abuse
  • Blood poisoning through black widow spider bite and carbon monoxide

When you call a doctor?

Since the erection is painful and lost lasting, you have no choice other than seeing a doctor.

What are the complications of priapism?

Ischemic priapism can lead to erectile dysfunction and change in anatomy of the penis in the future due to long lasting painful erections.

Diagnosis of priapism

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Your doctor will carefully analyze your condition and check your medical history of disease or trauma and drug intake. He/she will enquire about the duration of the erection and also about your sexual health.  

Physical analysis of the abdomen and rectum may also be done to diagnose presence of abnormal growth like tumors.

The diagnostic test for priapism is blood gas measurement. In this test, your doctor will insert a tiny needle in your penis to draw blood. The color of the blood will help determine the type of priapism. Dark color, oxygen deprived blood indicates low flow while normal red color of blood represents high flow. The blood will be further tested for quantitative analysis of various other kinds of gases.

If you are a patient of blood disorder or if your doctor suspects it, then you will have to undergo complete blood count tests for determining platelets and red blood cells.

Blood and urine tests are recommended to confirm presence of toxic substances in your body. Lastly, you might need to undergo ultrasonography to study penile blood flow and also to check an underlying trauma or injury.

Treatment of priapism

The situation demands emergency care, so the first line of treatment is- draining blood out of the penis. To end the erection, blood is aspirated from the penis with a syringe.

Secondly a group of drugs known as alpha-adrenergic sympathomimetic, is injected in the spongy tissue of the penis. It narrows those tissues and stops blood flow to the penis. On the contrary, blood vessels that carry blood out of the penis get dilated and hence the erection goes off.

Surgery is also an option wherein a device is implanted to reroute penile blood flow.  

Worth to mention, the treatment also involves curing the primary health disorder to avoid future episodes of priapism.

Can priapism be prevented?

It can be prevented by treating the underlying blood disorders and eliminating the risk factors like use of illegal drugs, alcohol abuse and over indulging in sexual stimulants.

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Written by: Saptakee sengupta
Date last updated: January 29, 2015