What is Priapism?

Priapism is a medical disorder in which the penis remains constantly erect and normally painful for several hours or more. It is a medical emergency that, if left untreated, may result in permanent penis damage. A single instance can influence future erection capability.

The surface of the penis is difficult and often painful during an incident of priapism. The penis head can continue to be soft.

Why does it happen?

During sexual arousal, the arteries supplying blood to the penis open up. This causes stiffness by increasing the volume and pressure of blood in the penis. If blood gets stuck in the engorged hard penis and does not flow naturally away at the end of arousal, the penis will remain hard and liable to harm for a few hours.

What causes priapism?

Priapism is caused by any disease that induces a buildup of blood and pressure or prevents its release.

a) Physical causes

It is more common in men who have a propensity for their blood to thicken and become sticky. This can happen in both inherited conditions like sickle cell anaemia and acquired conditions like lymphoma and myeloma.

Congenital or acquired spinal injury may affect the nervous system of the penis and disrupt normal blood flow.

Blood flow may be affected by injuries to the base of the penis and the region around the anus, as well as growths such as bladder and prostate cancer.

b) Prescription medicines

Some prescription medications are linked to an increased risk of priapism, but the risk is still low. Sildenafil (Viagra, Cenforce 100), tadalafil (Cialis, Vidalista 20), avanafil (Spedra), and vardenafil (Levitra, Vilitra 60) have all been reported as potential causes, as have alprostadil-containing topical medications for erectile dysfunction, such as Vitaros cream. It’s worth repeating because the risk is minimal.

Other medications that can induce priapism include antidepressants like Prozac, anticoagulants like warfarin and heparin, and blood pressure medications known as calcium channel blockers.

Treatment

There is an immediate need to clear the accumulated blood and lower the pressure within a few hours. This should be done in a hospital’s emergency department. Blood may be extracted directly from the penis by inserting large-bore needles into the erectile tissue on either side of the shaft. To decrease inward and improve external blood flow, dilute phenylephedrine (adrenaline) may be injected into the penis. During administration, side effects such as fast heart rate and elevated blood pressure must be controlled.

If other methods failed, surgical procedures can be performed to relieve the pressure. This is usually a last-resort treatment.

Important points

Priapism is rare in mostly stable males. It is a medical emergency that requires immediate medical attention within hours to prevent permanent damage. Some men with pre-existing health issues are at a higher risk.

Some medications, most notably those used to treat erectile dysfunction, directly cause the disease, particularly when combined with other medications.

Treatment is available, but it is not without problems and difficulties.