Priapism is a prolonged, unwanted erection of the penis that persists for hours and is not associated with sexual arousal or desire. The erection is rigid and painful and occurs without stimulation. Priapism is considered a medical emergency that requires prompt treatment. If not treated early, it can result in permanent erectile dysfunction or damage to the penis.
Types of Priapism
There are two main types of priapism:
Low-flow (ischemic) priapism
This is the most common type, accounting for about 95% of priapism cases. It occurs when blood cannot adequately drain out of the penis. Blood becomes trapped in the penis, creating pressure and causing pain and swelling. This type deprives the penis of oxygen and can damage tissue over time.
High-flow (non-ischemic) priapism
This rare type happens when unregulated blood flows into the penis too rapidly. The influx of blood develops into an uncontrolled erection. This type is usually not as painful or distressing as ischemic priapism.
What Causes Priapism?
Several medical conditions and factors can trigger priapism:
- Sickle cell disease: This blood disorder causes red blood cells to become misshapen and disrupt blood flow. It is the most common cause in children.
- Leukemia and other blood cancers: These cancers affect blood cell production and circulation. The malignancies or their treatments can impair blood flow.
- Spinal cord injury or trauma: Injury to the spinal cord or genital region can disrupt nervous system signals that regulate erections.
- Medications: Drugs like anticoagulants, antidepressants, blood pressure medications, and others can affect blood flow.
- Recreational drugs and alcohol: Substances like cocaine, marijuana, and alcohol use have been linked to priapism.
- Spider bites: The venom from some spider bites like the black widow may cause priapism.
- Metabolic disorders: Conditions like gout, amyloidosis, and Fabry disease can increase risk.
- Blood clots or thrombosis: Clots blocking drainage in the penis can lead to trapped blood.
Symptoms of Priapism
The main symptoms of priapism include:
- An erection lasting over 4 hours without any sexual stimulation or arousal
- The erect penis is rigid and painful
- The penis is tender or throbbing constantly
- Complete lack of sensation in the penis
- Numbness or tingling in the penis
- The glans penis looks swollen and discolored
- Weak urine stream or inability to urinate
If you experience an erection lasting over 4 hours, seek immediate medical attention, even if the erection subsides on its own. Prolonged priapism can cause permanent penile damage.
Diagnosing Priapism
To diagnose priapism, a kapeefit online ayurvedic consultation doctor will review your medical history and examine the penis and testicles. They will check for rigidity, pain level, and loss of sensation.
Other tests used to diagnose priapism include:
- Blood gas analysis: A blood sample from the penis determines oxygen and carbon dioxide levels. This helps distinguish ischemic vs non-ischemic priapism.
- Penile blood aspirate: Inserting a small needle into the penis to draw blood can show if blood is diluted or thickened.
- ** Doppler ultrasound**: This imaging test measures blood flow in the penis to locate blockages.
- MRI or CT scan: Provides images of the penis to visualize any abnormalities.
- Nocturnal penile tumescence test: Monitors erections during sleep to check for underlying conditions.
Treatments for Priapism
The treatments for priapism vary depending on the cause and type. The main goal is restoring normal blood circulation in the penis as soon as possible to prevent permanent erectile dysfunction.
Medications
Medications that help restrict blood vessel dilation and blood flow are often the first line of treatment:
- Alpha-adrenergic agonists: Examples are pseudoephedrine and phenylephrine. They stimulate alpha receptors to cause blood vessel constriction.
- Anti-androgens: Like spironolactone and bicalutamide. They block male sex hormones involved in erections.
Surgery and Aspiration
If medications are ineffective, excess blood trapped in the penis may need to be removed. Procedures include:
- Aspiration: Using a small needle to drain blood from the corpus cavernosum.
- Surgical shunts: Creating a passageway for blood drainage from the penis.
- Embolization: Blocking off a damaged vein to redirect blood flow.
Treating Underlying Conditions
It’s crucial to identify and properly treat any underlying illnesses, disorders, or cancer that could be causing priapism. This helps prevent recurrence.
Preventive Care
Some preventive measures can reduce priapism risk, such as:
- Avoiding recreational drugs and alcohol
- Using medications only as prescribed
- Getting early treatment for sickle cell disease
- Managing other medical conditions properly
- Openly communicating with doctors about any unwanted, persistent erections
Potential Complications of Priapism
Leaving priapism untreated for prolonged periods can lead to serious consequences:
- Permanent erectile dysfunction: Due to oxygen deprivation and scarring of penile tissue. This happens in over 30% of ischemic priapism cases.
- Penile deformity or shrinkage: Tissue damage can cause painful curvature of the penis upon erection.
- Difficulty urinating: Resulting from swollen, inflamed urethras. It may require a catheter.
- Gangrene or necrosis: Dead tissue in the penis may require surgical removal.
- Severe infection: Like Fournier’s gangrene, a rare but life-threatening infection of the genital area.
- Infertility: Priapism-related erectile dysfunction can make it difficult to conceive children naturally.
When to See a Doctor
You should seek emergency medical care for an erection lasting over 4 hours. The sooner priapism is treated, the less likelihood of permanent impotence or tissue injury.
See your doctor promptly if you experience recurring unwanted erections, especially upon waking up. This may indicate an underlying medical disorder requiring treatment.
Be sure to also mention any medications you’re taking since different drugs can potentially cause or contribute to priapism as a side effect.
Conclusion
Priapism is a serious medical condition requiring urgent kapeefit online ayurvedic consultation for erectile dysfunction to prevent complications like erectile dysfunction. Seek immediate medical care if an erection persists abnormally long without stimulation.
Controlling any underlying diseases and avoiding priapism triggers can also help reduce occurrence. With prompt diagnosis and treatment, the outlook for most cases of priapism is positive.
