Priapism

Priapism is the medical term for a persistent erection that lasts at least 4 hours. It is usually painful, and may not be related to sexual stimulation or activity. Left untreated, it can cause lasting damage to the penis.

During a normal erection, blood flows into the penis and is kept there because the veins become compressed by the swollen muscles.

After ejaculation, hormones make the arteries get narrower, which releases the pressure on the veins, so that the blood can drain out again. With priapism, this doesn't always happen.

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Priapism symptoms

In 35% of cases, priapism has no obvious cause. In other cases, priapism occurs as a result of medical treatment, trauma, medications, alcohol abuse, or an underlying blood or nervous system disorder such as sickle-cell anaemia. Priapism as a side effect of injection therapy for erectile dysfunction is only a 1 in 1,000 chance.

The main symptom of priapism is an erection that will not go away. If you have had an erection for more than four hours, seek medical help from the nearest Accident and Emergency department.

In rare cases, if the erection is left for too long, severe damage to the tissues in the penis can result. This may affect future erections. It is therefore very important to see a doctor as soon as possible.

Priapism diagnosis

Although the doctor will be able to clearly see your problem, it is important to try and find out the reason why it has occurred. Your doctor will take a detailed history from you and will want to know if priapism has ever happened before.

You will also have a physical examination to look for trauma to the penis. If the underlying cause cannot be found, you may need blood and urine tests to check for any underlying medical conditions.

Priapism treatment

Many cases get better on their own after repeated ejaculation, or after physical activity such as a brisk walk. However, if these measures do not work, then a doctor may try one of several methods.

For example, blood may be removed from your penis through a needle. If this method does not work, another medication, which works like a reversing agent, may be injected into the penis. In very rare cases, surgery may be needed to avoid permanent damage to the tissues of the penis.

Need more information?

Speak to your GP or consultant if you notice any symptoms or to discuss priapism treatment options.

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