What is Priapism? Simply put...
Simply put, priapism is the condition in which the penis remains erect for a prolonged period of time, usually more than four hours, without any sexual stimulation or desire. Most importantly, it is usually very painful. This happens because the blood that has flowed into the penis, that is, the blood, cannot flow back into the body and becomes trapped inside the penis.Think of it like a balloon filled with water that has no way to escape when you tie it shut. The same thing happens to the penis.It is important to remember that this is a medical emergency. It is important to seek medical attention immediately, that is, as soon as possible. If left untreated, it can cause permanent damage to the penis and even lead to conditions such as erectile dysfunction (ED) in the future.
Are there main types of priapism?
Yes, priapism can be divided into several main types. Each type has a slightly different onset and symptoms.1. Low-flow (ischemic) priapism
This is the most common type of priapism. What happens here is that blood that has entered the special chambers (corpora cavernosa) that contribute to the erection of the penis, gets stuck and cannot get out again. To be precise, the blood flow is reduced, which is why it is called "low-flow". Sometimes it is not possible to find a specific cause for this. However, it can occur more often in people with certain medical conditions. For example:- Sickle cell disease - This is a genetic blood disease.
- Blood cancer (Leukemia)
- Malaria
2. Recurrent (stuttering) priapism
This is also a type of low-flow priapism, but it is a slightly different condition. What happens here is that the penis becomes erect for a long time, then spontaneously becomes erect again after a short time. This can happen repeatedly. Each time the erect period increases and the pain increases.3. High-flow (nonischemic) priapism
This type is a little rarer than the other two. It occurs when an injury or trauma to the penis or the area around it (for example, the perineum ) causes an uncontrolled flow of blood into the penis. This is called "high-flow." This type is usually less painful than the other types.How common is this condition called priapism?
Priapism is generally a relatively rare condition. However, as I mentioned earlier, it is more likely to occur in people with certain underlying medical conditions. For example, it can occur in 30% to 45% of people with sickle cell disease .What are the symptoms of priapism? How do you recognize it?
The main symptom is that the penis remains erect for more than four hours without any sexual stimulation. Other symptoms may vary depending on the type of priapism you have. If you have low-flow (ischemic) priapism:- Even if the shaft of the penis is erect, the glans (tip) may be soft.
- The pain gradually increases over time.
- The shaft of the penis may not be completely rigid, but may be slightly flexible.
- There is usually no pain or very little pain.
What are the main causes of priapism?
Surprisingly, in about one-third (33%) of priapism cases, no specific cause can be found. However, in the rest of the cases, multiple factors may play a role. Low-flow (ischemic) priapism can be caused by underlying health conditions:- Sickle cell disease
- Blood cancer (Leukemia)
- Malaria
- Thalassemias
- Black widow spider bites
- Carbon monoxide (CO) poisoning
- Penile cancer
- Injuries to the spine or genital area
- Use of certain illegal drugs: Examples include marijuana , cocaine(cocaine) and amphetamines .
- Use or misuse of certain medications:
- Medications for sexual dysfunction: For example , phosphodiesterase type 5 inhibitors and intracavernous injection therapy .
- Some antidepressant medications : For example , trazodone .
- Some antipsychotic /neuroleptic medications : For example , chlorpromazine .
Is this disease called priapism contagious?
No, not at all. Priapism is not a contagious disease. Also, it is not a sexually transmitted infection (STI) or a symptom of such an infection. So there is nothing to worry about.Who is most likely to be affected by this situation?
Priapism can occur in anyone of any age with a penis. It can also occur in newborn babies, but it is most common in two age groups:- Boys between 5 and 10 years old.
- Young and older men between the ages of 20 and 50.
What are the possible complications of priapism? Is it serious?
Yes, this is the point we need to pay special attention to. If not treated properly, priapism can permanently damage the penis. Think about it, the cells in our body need oxygen to build energy. Oxygen comes from the blood. In priapism, when the blood gets stuck inside the penis, the oxygen in that blood gradually runs out. Then the tissues in the penis start to get damaged. The main complications that can occur due to untreated priapism are:- Scarring of the tissues inside the penis.
- Permanent sexual dysfunction (ED) . This means that the penis cannot be erect enough for sexual intercourse.
That's why we say, don't take this as a joke, don't be ashamed, and seek medical advice immediately.
How is priapism diagnosed? What does a doctor do?
If you feel like your penis has been erect for several hours, you should see a doctor immediately. The doctor will ask you about your medical history, take a note of your symptoms, and perform a physical exam. At this time, the doctor may ask you questions like:- How long does it take for the penis to become erect?
- How long does your penis usually stay erect?
- Do you have any other diagnosed medical conditions?
- Have you recently had an injury to your penis or the surrounding area?
- Are you currently taking any medications?
- Have you used any medication without a doctor's prescription?
- Do you use illegal drugs?
What kind of tests will be done?
After a physical exam, your doctor will measure the oxygen levels in your blood. This involves inserting a small needle into your penis and taking a small amount of blood and sending it to a lab. The test results can tell your doctor about:- What type of priapism do you have?
- How long has this been happening to you?
- This is how much damage has been done to the tissues of the penis.
How is priapism treated? Is there anything I can do at home?
No, don't try to treat this at home! The primary goal of all priapism treatments is to restore the erection and maintain the penis's ability to become erect normally in the future. If you think you have priapism, go to the emergency room immediately. Your doctor may first give you a decongestant , such as phenylephrine (e.g., Sudafed PE®). These medications work by reducing blood flow to the penis and helping to reduce the erection. These medications are most effective when given within the first four to six hours of the onset of priapism. Other treatment options include:- Aspiration : The doctor will first numb your penis, then use a small needle and syringe to draw out some of the oxygen-poor blood inside your penis. This will help reduce pressure and swelling. This may need to be done several times.
- Intracavernosal injection : The doctor injects medication into the corpus cavernosum (alpha-agonists) using a small needle.A type of medication called atropine is injected into the penis. These medications constrict the arteries that carry blood to the penis. This reduces blood flow and reduces swelling. This is a treatment specifically for low-flow (ischemic) priapism.
- Applying ice packs : Applying ice packs to the penis and the surrounding area can help reduce swelling.
- Surgical ligation : If an artery has burst due to an injury, a urologist will perform surgery to tie off the damaged artery and restore normal blood flow. This is a treatment for high-flow (non-ischemic) priapism.
- Surgical shunt : A specialist surgeon surgically creates a new blood vessel (shunt) inside the penis. This reroutes blood and restores normal circulation. This is a treatment for low-flow (ischemic) priapism.
Can this condition be cured by masturbation or sexual intercourse?
Usually not. Priapism does not go away even with masturbation, intercourse, or ejaculation. This is because it is not a normal sexual arousal.How soon will I feel better after treatment?
If the treatment is successful, it should relieve your priapism almost immediately. You may experience relief with the first treatment, or you may need to take several treatments. After treatment for priapism, your penis may feel a little sore and swollen. But it should not be hard or firm. Remember, everyone's body is different. Your recovery time may vary. Follow your doctor's instructions on how to manage any pain or discomfort until you recover.Can anything be done to prevent priapism?
These tips can help prevent priapism:- Get proper treatment for underlying conditions that may be causing priapism.
- Use medications only as prescribed by a doctor. Do not take any medication without medical advice.
- If you play sports or engage in physically active activities, wear an appropriate protective cover (athletic cup) to protect your penis.
How long does priapism usually last?
High-flow (non-ischemic) priapism can sometimes resolve on its own within a few hours or weeks without treatment. However, it is not wise to wait for it to resolve. However, low-flow (ischemic) priapism does not resolve on its own. It definitely requires medical attention.What is the outlook in this situation? Will it get better?
If you get treatment early, the outlook for most people is good. About half of people with low-flow priapism can regain normal erections if the condition is controlled within 24 hours . However, if you have low-flow priapism for more than 36 hours , you are more likely to develop permanent erectile dysfunction (ED) .If I have priapism, is there anything I can do until I see a doctor?
These things may help reduce the initial stiffness of the penis and relieve pain. But don't delay seeing a doctor just because you've tried these things.- Take painkillers (Nonsteroidal anti-inflammatory drugs - NSAIDs) . Not everyone can take these, so it's best to ask a doctor.
- Drink plenty of water.
- Try to urinate.
- Take a walk.
- Engage in light or moderate physical activity: For example, jumping rope, running in place, or exercises like squats .
When should I see a doctor? Should I go to an Emergency Department (ETU) ?
If you have repeated painful erections without sexual stimulation that go away on their own, talk to a doctor. After treatment, schedule a follow-up appointment with your doctor. If priapism recurs after treatment, call your doctor right away. Priapism is a medical emergency! If you have an erection without sexual stimulation that does not go away after a few hours, go to the nearest emergency room (ETU) immediately, without delay. The longer you wait, the greater the risk of permanent damage to your penis.What are the important questions I should ask the doctor?
When you see the doctor, you can ask questions like these:- How do you know for sure that I have priapism?
- Will my penis be permanently damaged?
- What type of priapism do I have?
- What is causing this situation for me?
- I am a urologist.Want to meet?
Can priapism occur even when I'm sleeping?
Yes, priapism can happen while you're sleeping. It's normal for your penis to become erect while you're sleeping (nocturnal penile tumescence) . However, the pain caused by priapism can wake you up. Also, it usually doesn't go away on its own, and it can be difficult to get back to sleep.Finally, the most important thing to remember!
Priapism is a condition that requires immediate treatment to prevent permanent damage to your penis. It can be embarrassing to have an erection that persists. However, priapism is different from a normal erection. It occurs without any sexual stimulation, and it is painful. It is your body's way of telling you that something is wrong. So, talk to a doctor as soon as possible and increase your chances of preventing permanent damage to your penis. Never delay seeking treatment because of embarrassment. Your health is the most important thing! Priapism, Penis Erection, Painful Erection, Penis Health, Men's Health, Emergency Medical Treatment, Penis👩🏽⚕️ Frequently Asked Questions (FAQ) from the Doctor
💬 Doctor, what is this priapism? Why is it so painful?
Priapism is a condition in which the penis remains erect for more than four hours without sexual stimulation. This is usually very painful. This happens because the blood that has entered the penis cannot return to the body and becomes trapped inside. It is like a balloon filled with water that cannot escape when the mouth is tied.
💬 Doctor, is this a serious situation? What should we do?
Yes, we consider this a medical emergency. This means that it is important to seek medical attention as soon as possible. Because, if left untreated, it can cause permanent damage to the penis, and it can also lead to problems like sexual dysfunction in the future. Therefore, if this happens, you should go to the nearest hospital without any delay.
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