Why Do I Have A Persistent Erection (Priapism)?
While many men are no doubt familiar with erectile dysfunction (ED), it’s unlikely that many of them are aware of the condition known as Priapism. Priapism is defined as an erection that lasts longer than 4 hours. A prolonged, painful penile erection persisting for more than four hours is not associated with sexual arousal, but rather a failure of blood to drain from the penis after it flows there during the onset of the erection. When not immediately treated, this condition can lead to scarring and permanent inability to achieve an erection. There are three types of priapism:
- Ischemic priapism (low-flow) 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 than the ischemic form.
- Stuttering priapism is the third category of priapism. In stuttering priapism, the erection occurs repeatedly but is transient in nature.
What Are The Symptoms?
The symptoms of this condition vary depending on whether you experience low-flow or high-flow priapism. If you have low-flow priapism, you may experience:
- erections lasting for more than four hours
- rigid penile shaft with a soft tip
- penis pain
If you have high-flow priapism, you’ll have some of the same symptoms as low-flow priapism. The main difference is that pain doesn’t occur with high-flow priapism.
What Causes Priapism?
Priapism occurs when some part of this system — the blood, blood vessels, smooth muscles or nerves — changes normal blood flow. Subsequently, the erection persists. While the underlying cause of priapism often can’t be determined, several conditions are believed to play a role. The most common causes are:
- sickle cell anemia
- Medications (A common cause of priapism is the use and/or misuse of medications including drugs for depression and mental illness)
- spinal cord disorder
- inflammation of the urethra
- leukemia (children with priapism usually have leukemia.)
- injury to the blood vessel that controls erection
- excessive response to alprostadil therapy for impotence
How Is Priapism Diagnosed?
The cause of disease must be rapidly identified and treated in the case of low-flow priapism. General investigations should include urine samples for the detection of infection and blood in the urine from trauma, and a variety of blood tests to search for an underlying cause of the priapism.
How Is Priapism Treated?
Treatment for priapism depends on whether you have low-flow or high-flow priapism. If you have low-flow priapism, your doctor may use a needle and syringe to remove excess blood from your penis. This can relieve pain and stop involuntary erections. If you have high-flow priapism, immediate treatment may not be necessary. This type of priapism often goes away on its own. Your doctor may check your condition before prescribing a treatment. Cold therapy with ice packs can get rid of an involuntary erection. Sometimes, doctors may suggest surgery to stop blood flow to the penis, or to repair arteries damaged by an injury to the penis.
While priapism is an infrequent occurrence, it is considered a medical emergency, as it can damage the tissue of the penis, potentially causing disfigurement and permanent erectile dysfunction. Therefore, it is very important to seek immediate medical care if you have an erection lasting more than a few hours.