Priapism is a rare medical condition that results in lengthy, painful erections that can persist for more than four hours.
The erections caused by priapism occur without sexual stimulation.
Priapism results when blood gets stuck in the erection chamber and can’t flow back out. This is called low-flow priapism.
On the other hand, high-flow priapism results from a broken or damaged artery that cannot propagate backflow from the chamber and keeps the blood stuck there.
High-flow priapism may be the result of an injury.
Although priapism is rare, males in their 30s are the most susceptible to it.
Why is Priapism Dangerous?
Having an erection for longer than four hours can lead to a medical emergency.
Since the same blood is locked into your erection chamber, the penis does not get fresh oxygen.
The penile tissues can grow weaker and sustain damage if you do not seek immediate medical help.
Untreated priapism may cause extensive damage to your penile tissue and may even result in permanent erectile dysfunction.
Signs and Symptoms
The most common sign of priapism is a persistent erection that may last more than four hours.
Moreover, the rigid penis may have a soft tip, as the blood will be concentrated in the shaft.
Your penis will begin to hurt after a while as the tissues get strained by overexertion.
Low-flow priapism can become a persistent condition. It may start with erections that last a few minutes.
However, they will begin to last longer with time, ultimately persisting for hours.
High-flow priapism exhibits the same symptoms as low-flow, except that there is no pain in the penis.
Either way, an erection that lasts for more than four hours is directly treated as a medical emergency.
Causes
Irregular blood flow in the penis is what results in priapism.
A regular erection is caused by increased blood flow to the erection chamber, which then flows out when stimulation ends.
However, medical conditions can cause sustained irregular blood flow in and out of the penis, such as:
Leukemia
Sickle cell anemia
Multiple myeloma
According to studies, around 42% of people with sickle cell anemia tend to face priapism at least once during their lives.
Priapism can also occur due to medication, the use of marijuana, several illegal drugs, and alcohol abuse.
Medicine such as blood thinners, antidepressants, alpha-blockers, and hormone therapy can cause priapism.
Medication for erectile dysfunction can also result in priapism.
Diagnosis
Although the symptoms are obvious, doctors still need to perform tests to find out if the priapism is low-flow or high-flow.
Tests to diagnose priapism include ultrasounds, blood tests, blood gas measurement, and toxicology tests.
The penile tissue being low on oxygen is an indication of low-flow priapism, something that is determined by the blood gas measurement.
Treatment
Treatment for priapism depends on the type you have.
For low-flow priapism, a needle might be used to simply take the excess blood out of the penis.
Another option may be to inject the penis with medication that shrinks blood vessels and sends blood out of the erection chamber.
High-flow priapism does not always require immediate medical attention as it tends to go away rather quickly.
A simple ice pack can help.
In persistent cases of priapism, doctors may prescribe decongestants such as phenylephrine, medication for erectile dysfunction, or hormone-blocking medications.
