Priapismus – Causes, Symptoms, Diagnosis, and Treatment


Priapismus is a prolonged erection of the penis. Erection that lasts continuously for hours after or not caused by sexual stimulation. This prolonged priapism is usually painful.

While Erection cannot occur if there is not enough blood flow. When a man is aroused, the arteries in the pelvis and penis relax and dilate, bringing more blood in order to tighten the penis. At the same time, the vein valve closes, so that the blood collected in the penis is trapped (not returning directly to the heart) so that the penis is enlarged and erect. After the erection is complete, the valve from the venous vein opens, then blood flow flows out, and the penis returns to its original size.

Abnormal blood flow can cause priapism, which is an erection that occurs at least 4 hours, usually the patient will feel pain, and can occur without any sexual stimulation. Priapismus occurs in men of all ages, including babies.

Priapismus has 2 main types:

  • Ischemic priapism or slow flow: This type occurs when blood is trapped in the erectile chamber. There is no clear cause, but this can affect men with sickle cell disease (crescent shaped red blood cells), leukemia (blood cancer), or malaria. If you don’t get immediate treatment, this can cause permanent erectile dysfunction
  • Non-ischemic prickism or fast flow: This type is less frequent than the slow flow, and usually not too painful. This often occurs when there is an injury to the penis, or the area between the scrotum and anus, called the perineum, has broken blood vessels, which prevents blood from moving from the penis to normal.

Causes of Priapismus

Erection usually occurs in response to physical or psychological stimulation. This stimulation causes certain blood vessels and smooth muscles to relax or expand, increasing blood flow to tissues that project on the penis. As a result, the penis filled with blood becomes an erection. After stimulation ends, blood flows out and the penis returns to a non-rigid state.

Priapism occurs when some part of this system – blood, blood vessels, smooth muscle or nerves – changes normal blood flow. Furthermore, the erection continues. While the cause of priapism may be certain, some conditions are believed to play a role.

Scientists think about 42 percent of men with sickle cell anemia will experience priapism at a time.

Many men get priapism when they use or abuse several types of drugs. Medications that can cause priapism include trazodone HCL (Desyrel) , or chlorpromazine (Thorazine) depression medication, which is used for several mental illnesses. Pills or injections that treat erectile dysfunction can also cause priapism.

Other causes :

  • Injury to the spinal cord or genital area
  • Black widow spider bites and scorpion stings
  • Carbon monoxide poisoning
  • Use drugs like marijuana and cocaine

This is rare, but priapism can occur due to cancer that affects the penis and prevents blood from flowing out of the area.

Priapismus symptoms

Symptoms vary depending on the type of priapism. The two main priapism types are ischemic and non-ischemic priapism.

Ischemic Priapism
Ischemic priapism, also called low-flow priapism, is the result of blood that cannot leave the penis. This is a more common type of priapism. Signs and symptoms include:

  • Erection lasts more than four hours or is not related to sexual interest or stimulation
  • The penis shaft is stiff, but the tip of the penis (glans) is soft
  • Progressive penile pain

Repeated or stuttering priapism, a form of ischemic priapism, is an unusual condition. This is more common in men who have a hereditary disorder characterized by abnormal red blood cells (sickle cell anemia). Sickle cells can block blood vessels in the penis. Recurrent priapism describes recurrent episodes of prolonged erection and often includes episodes of ischemic priapism. In some cases, this condition begins with an undesirable and painful erection with a short duration and can develop over time for erections that are more frequent and longer.

Non-ischemic priapism, also known as high-flow priapism, occurs when penile blood flow is not properly regulated. Non-ischemic priapism is usually painless. Signs and symptoms include:

  • Erection lasts more than four hours or is not related to sexual interest or stimulation
  • The penis’s penis is erect, but not completely stiff

Priapismus diagnosis

If you think you might have priapism, you need to get medical treatment as soon as possible. The Dikter might ask you:

  • How long have you been erect?
  • How long is it usually when you are corrected?
  • What medicines, legal or illegal, have been used?
  • Does priapism occur after an injury?

Your doctor will review your medical history and conduct a thorough physical examination to find out what caused your problem. The doctor will examine the rectum and stomach for any signs of cancer. You may also need to see a urologist for more screening tests, including:

  • Blood test
  • An imaging test called colored Doppler ultrasound, which shows blood flow in your penis
  • An X-ray is called an arteriogram that detects dyes injected by the doctor before into the arteries

Treating Priapismus

The goal of treatment is to eliminate priapism and prevent erectile dysfunction. Handling options include:

  • Ice Compress : Ice packs can reduce swelling for fast flow priapism
  • Taking blood: After the doctor has anesthetized or numbed your penis, the doctor will use a needle to draw blood to reduce the pressure and swelling of the penis
  • Medications: For slow flow primers, doctors can inject drugs called alpha-agonists into your penis. This drug makes blood vessels narrow, so the blood to the penis area is reduced and reduces swelling. This drug can be available in the form of pills or injections, so the procedure for administering this drug does not always have to be injected
  • Lock arteries : A doctor will block blood vessels that cause problems, this procedure is called arterial embolization. Doctors sometimes use it for fast flow priapism
  • Binding to dead arteries : When the arteries rupture causing priapism, the doctor will perform an operation to bind to the dead arteries, called surgical ligation. This is also done to overcome fast-flow priapism
  • Shunt surgery : The doctor will make a way so that the penis allows it to drain the blood. This is the best procedure for low-flow individuals, but someone is free from the risk of erectile dysfunction later on.

If you think you have priapism, don’t try to treat it yourself. Instead, get emergency treatment as soon as possible. Most people recover completely when they get treatment quickly. But the longer you go without medical treatment, the greater the eternal risk of getting an erection.