What is the definition of priapism?
Priapism is a prolonged, unwanted erection of the penis. It is usually painful and not related to sexual stimulation or arousal. Most clinicians consider priapism a medical emergency because the condition can result in impotence, sexual dysfunction or penile infection.
What causes priapism?
A normal erection occurs in response to sexual stimulation. Priapism occurs in several conditions that interfere with the blood flow to the penis or blood drainage from the penis. This condition is unrelated to sexual stimulation and can last for several hours. Below are some of the causes of priapism.
Medical conditions that can cause priapism:
Trauma as a cause of priapism:
- Direct trauma to the penis, pelvis, or perineum
- Spinal cord injuries
Medications (several drugs have priapism as a side effect):
What are the symptoms of priapism?
Priapism results in a persistent erection. Priapism is usually divided into three categories.
- Ischemic priapism is the most common category of priapism. Blood is not able to leave the penis causing the erection. This painful event is considered an emergency if it lasts for more than 4 hours.
- Non-ischemic (high-flow) priapism is the second category of priapism, and much less common. In this form, too much blood flows into the penis. The erection tends to be painless and less rigid then the ischemic form.
- Suttering priapism is the third category of priapism. In stuttering priapism, the erection occurs repeatedly but is transient in nature.
How is priapism diagnosed?
The diagnosis of priapism is based on history (asking the patient questions) and the physical exam of the genitalia. Once a health care professional has finished this part of the exam a few other tests might be ordered.
- Measurement of blood gas: By inserting a small needle and removing blood from the penis the doctor will be able to establish the oxygen content and therefore the type of priapism the patient has.
- Blood tests: Measuring white and red blood cells and platelets will help the health care professional determine why the patient might have a priapism.
What is the treatment for priapism?
The treatment of ischemic priapism includes several modalities and will depend on how long the priapism has been present, and the results of the blood tests. These interventions are performed in a step wise fashion with surgery being the last resort. Unfortunately, some of the treatments of priapism can lead to erectile dysfunction in the future.
Treatments for priapism are as follows:
- Aspiration: Blood is drained from the penis using a 16 or 18 gauge needle and syringe.
- Medication: A medication that constricts blood vessels that carry blood into the penis (Alpha Adrenergic Sympathomimetic; phenylephrine) is injected into the penis using a small (29 gauge) needle into the corpora cavernosa area of the penis.
- Surgery: A surgical procedure that reroutes blood can be performed.
Ice to the area around the genitals is sometime utilized. In severe cases surgical procedures are available.
Non-ischemic priapism is usually not an emergency and will frequently resolve without interventions.
What are the complications of priapism?
Ischemic priapism can cause significant complications. Due to the lack of oxygen, there can be significant damage if priapism lasts for more than four hours. The complications include erectile dysfunction as well as disfigurement of the penis.
When to see a health care professional
A painful erection lasting for more than 4 hours should trigger an emergency department visit. If the unwanted erection resolves in less than four hours a nonemergent doctor's visit should be scheduled.
Can priapism be prevented?
Priapism or recurrence of priapism can be prevented by treating the underlying medical cause that resulted in priapism or changing medications that have priapism as their side effects. No medications should be discontinued or changed until you speak with your healthcare provider.
Latest Men's Health News
Daily Health News
Health Solutions From Our Sponsors
"Priapism." MedscapeReference.com. Updated Oct. 15, 2015.
Top Priapism (Penis Disorder) Related Articles
Antidepressants (Depression Medications)
Depression medications or antidepressants are drugs prescribed for treating depression. There are several types of drug classes of antidepressants including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).
Side effects depend on the medication prescribed. Drug interactions, warnings and precautions, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
Balanitis (Inflammation of the Head of the Penis)
Balanitis is a condition in which the skin of the head of the penis becomes inflamed. If the foreskin is also inflamed, it is referred to as balanoposthitis. Balanitis usually occurs in uncircumcised males with symptoms of pain, swelling, and redness at the head of the penis. Often, balanitis is caused by poor hygiene or some medical conditions such as diabetes, and yeast infections. Treatment for balanitis is directed at the cause of the condition and may include creams or other medications.
Balanitis is not an STD; however, it may have similar symptoms.
Early Signs and Symptoms of Penis CancerPenile cancer is a relatively rare type of cancer arising from the skin and tissues of the penis. It affects the skin and tissues of the penis. It occurs when normal cells in the penis become cancerous and grow rapidly out of control, forming a tumor. Penile cancer can spread to other parts of the body.
Erectile Dysfunction (ED, Impotence)Erectile dysfunction (ED, impotence) is the failure to achieve or maintain an erection. There are many potential underlying causes of erectile dysfunction, including stress and emotional problems, brain dysfunction, problems with blood supply to the penis, and structural problems with the penis.
LeukemiaLeukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Penis CancerSigns and symptoms of penile cancer include a lump on the penis and redness, irritation, or a sore on the penis. Risk of penis cancer is higher in uncircumcised men, due to a higher risk of HPV infection. Other risk factors include being over 60, having phimosis, having poor hygiene, using tobacco products, and having many sex partners. Prognosis and treatment depend upon the tumor's location and size, the stage of the cancer, and whether the cancer was recently diagnosed or if it recurred.
Penis DisordersPenis disorders (male reproductive problems) include priapism, Peyronie's disease, balanitis, phimosis, paraphimosis, and penile cancer. Read on for causes, symptoms, diagnosis, and treatment. These disorders can affect a man's fertility and sexual functioning. A variety of treatments are available for these disorders.
Penis PictureThe penis is the male sex organ, reaching its full size during puberty. See a picture of the Penis and learn more about the health topic.
Penis PumpVacuum constriction devices, or penis pumps, may be useful in the treatment of erectile dysfunction (impotence). A penis pump is an acrylic cylinder with a pump that can be attached to the end of the penis. The pump then creates a vacuum to help the penis become erect, while a constriction ring maintains the erection.
Peyronie's Disease (Curvature of the Penis)Peyronie's disease or curvature of the penis (Peyronie disease) is a condition in which scar tissue develops inside the penis. This scar tissue causes the penis to develop an abnormal curvature in the scarred area. At this time, there is no known cause of Peyronie's disease. Symptoms of Peyronie's disease include pain during intercourse or ejaculation, erectile dysfunction (ED, impotence), the inability to have sexual intercourse, anxiety, stress, an indentation of the shaft at the site where there is plaque or scarring, and an angulation of the penis when erect or flaccid. There is no cure for Peyronie's disease, however, there are medications that can reduce symptoms of the disease. Surgery or penile implants may be an option for severe cases.
Phimosis (Paraphimosis)Phimosis and paraphimosis are penis disorders. Phimosis is a condition where the foreskin can't retract behind the head of the penis. Symptoms can lead to swelling of the penis, or painful erection and urination. Paraphimosis is a condition that occurs when the foreskin is retracted behind the head of the penis and can't return to it's original position. Symptoms include pain and swelling of the penis. You need to be treated by a doctor or other healthcare professional for these penis problems.
Sexual Problems in MenMale sexual dysfunction can be caused by physical or psychological problems. Common sexual problems in men include erectile dysfunction (impotence or ED), premature ejaculation, and loss of libido. Treatment for sexual dysfunction in men may involve medication, hormone therapy, psychological therapy, and the use of mechanical aids.
Sickle Cell Disease (Anemia)Sickle cell anemia (sickle cell disease), a blood disease which shortens life expectancy, is caused by an inherited abnormal hemoglobin.
Symptoms of sickle cell anemia may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury.
Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
Spinal Cord Injury: Treatments and RehabilitationWhen vertebrae are broken or dislocated, the result can cause traumatic injury to the spinal cord. A spinal cord injury can have significant physiological consequences. One indication of the severity of a spinal cord injury are respiratory complications. Spinal cord injuries are classified as either. Rehabilitation and recovery of a spinal cord injury is dependant upon the type of injury.
Types of Penis DisordersPenis disorders may affect men’s sexual life, fertility and overall well-being. Some are minor and don’t cause many issues. However, some may lead to serious emergencies. There are many different types of penis disorders.
warfarin (Coumadin, Jantoven)
Warfarin (Coumadin, Jantoven) is an anticoagulant drug that inhibits the blood from clotting, thus preventing blood clots. It is prescribed for the treatment of patients with deep vein thrombosis, the reduction of pulmonary embolism, and in patients with atrial fibrillation to reduce the risk of strokes and heart attack. Common side effects of warfarin include:
- Hair loss
Drug interactions, and warnings and precautions, and pregnancy and breastfeeding information should be reviewed prior to taking this medication.