- Priapism Penis Disorder Center
- Impotence Slideshow Pictures
- Sex-Drive Killers Slideshow: Causes of Low Libido
- Take the Low Testosterone Quiz
- Patient Comments: Priapism - Cause
- Find a local Doctor in your town
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):
Quick GuideEnlarged Prostate (BPH) Symptoms, Diagnosis, Treatment
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.
Daily Health News
Men's Health Resources
Subscribe to MedicineNet's Men's Health Newsletter
"Guideline on the Management of Priapism." American Urological Association.
"Priapism." MedscapeReference.com. Updated Oct. 15, 2015.
Top Priapism (Penis Disorder) Related Articles
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.
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. Erectile dysfunction is diagnosed by taking the patient's history and physical exam. Blood tests measuring kidney function and blood sugar, cholesterol, hormone, and prostate-specific antigen (PSA) levels may be ordered. Urinalysis, ultrasound, and other more sophisticated tests may be required. The treatment of erectile dysfunction depends on the underlying cause. Medications, penile injections, penile implants, and vacuum devices may be used. Treatment for erectile dysfunction is usually successful. The patient should manage heart disease risk factors (high blood pressure, high cholesterol, diabetes) as they are related to erectile dysfunction risk.
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).
Phimosis and Paraphimosis (Penis Disorders)
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 (Sex) 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 CellSickle cell anemia (sickle cell disease), a blood disease which shortens life expectancy, is cause by an inherited abnormal hemoglobin. Symptoms may include:
- bacterial infections,
- painful swelling of the hands and feet,
- leg ulcers,
- eye damage,
- and lung and heart injury.
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 complete or incomplete. Spinal cord injury affects can include:
- affected breathing,
- lower blood pressure,
- irregular heartbeat,
- blood clots,
- autonomic dysreflexia,
- bed sores (pressure sores),
- chronic pain,
- bladder and bowel problems, and
- reproductive and sexual function issues.
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.