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What is Priapism?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 16 November 2016
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Priapism is a medical emergency. In this condition, a man’s erection does not end after four hours. This can lead to significant pain and damage to the blood vessels and surrounding tissues of the penis.

Priapism has received some attention since the advent of medications like Viagra® and Cialis®, which can help men with erectile dysfunction maintain an erection through intercourse. Although the advantages to these medications are clear, on rare occasions priapism can occur and should warrant an immediate trip to the doctor or to an emergency room. Though this condition has been the subject of quite a bit of joking by comedians, it is definitely not comedic, and should be treated with great seriousness.

Priapism may also be caused by other conditions. Some genital infections, leukemia, or sickle-cell disease can cause priapism to manifest. As well, priapism may be the result of injury to the spine, which is, in itself, deserving of medical attention. Prolonged sexual activity can on very rare occasions also lead to this condition. Certain other medications like antidepressants and blood pressure medication may also increase risk for priapism.

Untreated priapism is associated with several severe complications. Risk for the blood clotting and causing a stroke is particularly high. As well, untreated priapism can result in infection of the penis leading to gangrene. In some cases, the only treatment of neglected priapism is amputation of the penis or scrotal tissue.

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This severe step is extremely unlikely if patients see a doctor immediately. The main treatment is to remove blood from the erect penis, a procedure done under local anesthesia. When this is not effective, a shunt may be placed which will allow the penis to drain of blood. Usually these treatments are successful and no further treatment is required.

However, a case of priapism warrants a full medical examination and evaluation to look for underlying causes that may require treatment. For example a person with a recent spinal injury might undergo X-rays to be certain the injury is not severe. Those who have priapism caused by a medication will likely take different medications in the future. Where a cause cannot be identified, physicians may run blood tests and scans to evaluate for blood disease, infection, or hormonal imbalances.

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