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The University of California San Francisco (UCSF) Medical Center defines priapism as an uncommon condition that causes long-lasting and often painful erection unrelated to sexual stimulation.
Unlike normal erection where the penis first fills with blood and then drains out, Columbia University’s Go Ask Alice column says priapism occurs when blood is unable to drain normally. The blood becomes stagnant and starts losing oxygen. Without oxygen, red blood cells become stiff, making proper drainage even more problematic.
Ischemic priapism is the most common. Sufferers endure several hours or days of painful unwanted erection. Cleveland Clinic says it’s the result of blood being trapped in the erection chambers. Mayo Clinic says symptoms include a rigid penile shaft and often soft penile tip; long-lasting erection unrelated to sexual stimulation or persistent after stimulation; and usually painful or tender penis.
Non-ischemic priapism isn’t as common or painful. Cleveland Clinic says it’s the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally. Other than unwanted erection unrelated to sexual stimulation, Mayo Clinic says symptoms include erect but not rigid penile shaft.
Go Ask Alice writes that most cases of priapism have clear medical explanations. Penile drug injections can lead to priapism, especially if the dose is higher than recommended. Alcohol or illicit drug abuse and certain drugs, like antidepressants, some blood pressure medications and blood thinners can cause priapism. So can blood clots and poisonous venom, according to Mayo Clinic.
Go Ask Alice adds medical conditions can also be the culprit; for example, sickle-cell anemia, leukemia or a ruptured spine or paralyzation.
WebMD warns if untreated, priapism can scar the penis and result in long term complication of erectile dysfunction.
Ischemic priapism treatment is usually a combination of draining blood from the penis and medication, according to Mayo Clinic. Cleveland Clinic says intracavernous injection is another. Alpha-agonists are injected into the penis causing the veins to narrow and reduction of blood flow. UCSF says another option is a surgical shunt to restore normal blood circulation.
Non-ischemic priapism often disappears without treatment. There isn't risk of penile damage, so doctors may suggest watching-and-waiting, says Mayo Clinic. When treatment is necessary, UCSF says embolization can reduce blood flow to the penis by obstructing the ruptured artery. Cleveland Clinic says surgical ligation is another option. A doctor ties off the artery causing the priapism in order to restore normal blood circulation.
WebMD adds if priapism is due to sickle-cell anemia, a blood transfusion may be necessary. Go Ask Alice says if it’s a result of penile trauma, surgery may restore normal function.
Sources:
Penis Disorders. WebMD.com by WebMD, LLC. Web 22 Nov 2011.
http://www.webmd.com/sexual-conditions/guide/sexual-health-male-reproductive-problems-penis-disorders
Priapism. ClevelandClinic.org by the Cleveland Clinic. Web 22 Nov 2011.
http://my.clevelandclinic.org/disorders/priapism/hic_priapism.aspx
Priapism. MayoClinic.com by the Mayo Foundation for Medical Education and Research. Web 22 Nov 2011.
http://www.mayoclinic.com/health/priapism/DS00873
What is Priapism? GoAskAlice.Columbia.edu by the Trustees of Columbia University in the City of New York. Web 22 Nov 2011.
http://www.goaskalice.columbia.edu/1133.html
Priapism. USCFHealth.org by the Regents of The University of California. Web 22 Nov 2011.
http://www.ucsfhealth.org/conditions/priapism/
Reviewed November 28, 2011
by Michele Blacksberg RN
Edited by Malu Banuelos
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