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Deepti Dogra

Priapism: The Penile Disorder That You Must Know About

Updated: Jul 20, 2023

Having a healthy erection is what every man always hopes for. However, did you know that you can get a painful erection for hours which can be harmful for your sexual health? Priapism is a penis disorder that can be quite damaging if not treated on time. Let’s get to know more about it.

Erection is the usual reaction of the body before you indulge in sexual activities. It ensures that you and your partner have a good time and keeps a check on you so that you don’t exhaust yourself. However, when you are not aroused but facing a painful erection, what are you supposed to do? Well, calling your Urologist would be the right and the best option.

Painful erection without any stimulus that goes on for hours is actually a penile disorder known as Priapism. Well it might not sound grave but if you’re facing it then immediately consult the doctor and get treated.

But if you want to know all about this condition then read it through!

What is Priapism?

Now that you have the basic idea of priapism, let’s delve deep into this topic. It is an uncommon penis disorder that can lead to erectile dysfunction and mostly occurs in certain men who are struggling with sickle cell disease.

Priapism mostly affects the men who are in their 30s or older, but has also been noticed in young boys who are suffering from sickle cell disease. According to a study in the *National Library of Medicine, sickle cell disease also accounts for a large number of cases of adult priapism, with rates reported between 40% and 80%.

There can be two types of Priapism; low flow and high flow:

  1. Low-flow priapism: This is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but it also affects men with sickle-cell disease, leukemia or malaria.

  2. High-flow priapism: This is rarer and is usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (the area between the scrotum and anus), which prevents blood in the penis from circulating normally.

Causes of Priapism

Be it low-flow or high-flow priapism, some of the common cause are:

Blood-related diseases might contribute to priapism. These disorders include:

  1. Sickle cell disease

  2. Leukemia

  3. Other blood diseases (hematologic dyscrasias), such as thalassemia and multiple myeloma

The most common associated diagnosis in kids is sickle cell disease.

Priapism can be the possible side effect of a number of drugs, including:

  1. Medications injected directly into the penis to treat erectile dysfunction, such as alprostadil (Caverject, Edex, others), papaverine, phentolamine (Oraverse) and others.

  2. Antidepressants, such as fluoxetine (Prozac), bupropion (Wellbutrin XL, Wellbutrin SR), trazodone and sertraline (Zoloft)

  3. Alpha blockers including prazosin (Minipress), terazosin, doxazosin (Cardura) and tamsulosin (Flomax)

  4. Medications used to treat anxiety or psychotic disorders, such as hydroxyzine (Vistaril), risperidone (Risperdal), olanzapine (Zyprexa), lithium (Lithobid), clozapine (Clozaril), chlorpromazine and thioridazine

  5. Blood thinners, such as warfarin (Jantoven) and heparin

  6. Hormones such as testosterone or gonadotropin-releasing hormone

  7. Medications used to treat attention-deficit/hyperactivity disorder (ADHD), such as methylphenidate (Concerta, Ritalin, others) and atomoxetine (Strattera)

Alcohol, marijuana, cocaine and other drugs can also cause priapism.

Trauma or injury to your penis, pelvis, or the region between the base of the penis and the anus (perineum) can also cause priapism.

Apart from these, various other factors can also lead to this penile disorder

  1. A spider bite, scorpion sting or other toxic infections.

  2. Metabolic disorders including gout or amyloidosis.

  3. Neurogenic disorders, such as a spinal cord injury or syphilis.

  4. Cancers involving the penis.

Treatments for Priapism

No matter what type of treatment your doctor opts for, it is only performed to make sure that the erection goes away as well as you don’t face the same issue in future. If a man is able to receive treatment within four to six hours, it is possible to reduce the erection with the help of medications. If the erection has lasted less than four hours, decongestant medications can decrease the blood flow in the penis and be quite helpful. The other type of treatments that are available for a man dealing with priapism are:

  1. Ice packs: Ice applied to the penis and perineum may reduce swelling.

  2. Surgical ligation: Used in some cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow.

  3. Intracavernous injection: This treatment is used for low-flow priapism. Drugs known as alpha-agonists are injected into the penis. They cause the arteries to narrow, reducing blood flow to the penis and causing the swelling to decrease.

  4. Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal.

  5. Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling.

Conclusion

Priapism can be a painful penis disorder as well as quite traumatic for a man. An erection lasting for hours can be dire and critical, when you just need to run to the emergency room! However, if you want to avoid such situations, make sure that you avoid consuming alcohol along with other substances, that would also put you in legal issues. Apart from that, do not take any medicines unless prescribed by a doctor. And if you do experience this penis disorder, do not delay the treatment at all!

Keynote

National Library of Medicine:

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