What is Priapism? Its Symptoms, Causes and Treatment

Priapism is a condition that can cause uncomfortable and painful erections. This happens in situation when an erection continues for up to four hours, or longer, without any sexual stimulation. Priapism is rare, but it does happen usually occurs in males who are aged 30 to 40.

The priapism types are:

• Low-flow or ischemic priapism
• High-flow or non-ischemic priapism

Ischemic Priapism

Ischemic priapism sometimes referred to as low-flow priapism, is caused by blood being unable to exit its penis. Blood gets trapped inside the penis because it cannot escape the veins in the penis, or there is an issue with the contraction of the smooth muscles in the penis’s erectile tissues. This also affects those who suffer from sickle-cell disease or leukemia.

High-Flow or Non-Ischemic Priapism

High-flow priapism can be caused by an inflow of blood that is not controlled by an obstruction between the cavernosal and corpus cavernosum. It is usually a result of penetrating or sharp injuries to the perineum or penis that causes rupture of a cavernous artery, and it’s not usually painful.

An emergency medical situation can occur if erection lasts for than four hours. The lack of oxygen in the blood vessels in your penis may cause damage to tissue located in your penis. On the off chance that not treated, priapism might cause the harm to the penile tissue and can lead to prolonged erectile dysfunction.

Although priapism is a rare disorder, it frequently happens in certain groups that have sickle cell diseases. However, the prompt treatment of priapism is typically required to avoid tissue damage, which could cause the inability to achieve or maintain sexual intimacy (erectile dysfunction). read more about erectile dysfunction in hindi

Priapism commonly influences men in their 30s and more established yet can start in youth for male who have sickle cell illnesses.

What Are The Priapism Symptoms?

The signs and symptoms of this disorder differ depending on whether you are experiencing high-flow or low-flow. If you experience low-flow priapism, you might be experiencing:

• Erections that last for longer than four hours
• The penile shaft is rigid and has an elongated tip
• penis pain

Ischemic priapism or low-flow can develop into a recurring condition. If priapism symptoms first begin with involuntary erections, they may last for just a few minutes or just a few minutes. Further, as time passes and the symptoms worsen, the erections will occur more and are more prolonged.

If you suffer from high-flow priapism, it will present the same symptoms in low-flow priapism. However, the primary distinction is that pain does not happen with high-flow priapism.

Priapism Causes

The erection usually happens in response to emotional or physical stimulation. The stimulation causes the muscle groups to relax, increasing blood flow to the spongy tissues within the penis, it is a way to increase blood flow to penis. In turn, the penis fills with blood becomes straight. After the stimulation goes, the blood stream stops, and the penis gets back to its flaccid state (non-rigid).

However, priapism causes when one element of this system, such as blood smooth muscles, vessels and nerves, alters blood flow, and the erection continues to last. The condition’s root cause is usually not clear; however, various conditions can involve.

Blood disorders

The presence of blood-related disorders can cause this condition, in which blood cannot flow through the penis.

Prescription Medication

Certain medications may affect nerves throughout the body, such as the penis. These nerves broaden the penis’s arteries, helping it to be erect and inflated.

Sickle-cell anemia

Certain abnormally-shaped red blood cells could obstruct the penile artery, leading to priapism. Approximately 40% to 42% percent of people who suffer from sickle-cell anemia eventually develop an underlying condition called priapism.

Injuries

A penile artery or trauma to the perineum or penis can stop blood circulation or draining. This is the most common reasons for non-ischemic priapism.

Other causes of priapism could be due to:

• A spinal cord injury or the genital region.
• Black widow spider bites.
• The use of drugs, for example, cocaine and marijuana.
• Carbon monoxide poisoning

In rare instances, the priapism cause condition may link to Penile Cancer or leukemia that could cause penis damage and hinder blood flow.

The causes are diverse, and people of everyone is affected. However, priapism is most often seen in males early in their childhood, between the ages of 5-10, and then in early adulthood, between ages 20 and 50.

 Priapism Diagnosis

Diagnosing priapism usually initiates with an extensive medical history and physical exam.

Tell your doctor:

• How long have you had an erection?
• How long does your erection typically last?
• Suppose you are consuming any drug or medication, whether legal or illicit. Talk to your doctor about it. Drug usage is particularly important as both cocaine and marijuana link with priapism.
•  If you are encountering priapism following any trauma to the body region.

The specialist will examine your clinical history and lead certain diagnostic test to decide the cause for your priapism.

The doctor will examine the genitals and the groin to identify the type of rigidity and whether traumas have taken place.

Sometimes, doctors instruct diagnostic tests instructed to get more details, the blood gas measurement. So, the procedure to do this is like this:

• A small amount of the blood from penis
• If the blood appears black, this indicates an ischemic priapism
• If the blood seems bright red, it’s non-ischemic priapism.

A doctor could also recommend:

• Blood tests
• urine toxicology
• ultrasounds

In addition to determining whether priapism is present, these tests help determine what might be the cause of the problem.

Priapism Treatment

Any treatment aims to stop the erection from going out and preserve the capacity to have erections again in the future. If an individual undergoes treatment within four to 6 hours, the erection can diminish through medications. If the erection lasts less than 4 hours, decongestants can decrease the flow of blood to the penis could be beneficial. Other options for treatment include:

Ice packs

Ice packs application to the penis and perineum to decrease swelling.

Surgery Ligation for Priapism

In some artery ruptures, the physician will then ligate (tie away) the artery responsible for the priapism to restore blood flow to normal.

Intracavernous injection

The treatment is for low-flow. Alpha-agonists, or drugs, are instilled directly into the penis. They cause the vessels to narrow, which reduces penis blood flow and causes swelling to reduce.

Shunt

A shunt is a channel precisely positioned inside the penis to redirect the blood stream and grant course to continue typical in case of low-flow.

Aspiration

After numbing the penis, the specialist will embed a needle to eliminate liquid from the penis to diminish pressure and swelling.

If you experience high-flow priapism, then immediate treatment might not be essential. The priapism of this kind usually disappears by itself. Moreover, your doctor can check the condition before prescribing treatment.

Also, ice packs or cold therapy can help eliminate involuntary sexual erection.  At times, specialists might prescribe a medical procedure to obstruct blood stream to the penis or to fix damaged arteries on the genitals.

Some priapism treatment at home includes:

1.  Place the cold pack or ice on the affected area for over 10-20 minutes at a stretch. Place a cloth between your penile region and the ice.
2. It is important to urinate regularly. Do not wait until you feel the need to.
3. Do not take any medication that caused a painful erection in the past.

If you suspect that you’re experiencing an onset of priapism, you shouldn’t try to treat it by yourself. Instead, seek out emergency help immediately.

Bottom Line

The likelihood of recovering from priapism is positive if you get prompt treatment. To ensure the best outcome, it’s crucial to seek assistance to prevent prolonged sexual erections, particularly if the issue is ongoing, not due to an injury and isn’t responding to the treatment with ice. If you don’t treat it untreated, it will increase the possibility of permanent Erectile dysfunction.

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Frequently Asked Questions

1. What causes priapism?

Some causes can include trauma to the genitals or genital region or Sickle-cell anemia. However, there can be other reasons too.

2. How do you get rid of priapism?

It depends on the priapism types you are encountering. If it’s low-flow, you will be experiencing pain and need treatment like medication or, in some cases, surgery.

3. Can priapism get heal by itself?

If you experience a high flow, then immediate treatment is not always necessary. This kind of priapism usually goes on its own. Further, the doctor will examine your condition prior to prescribing treatment. Cold therapy using ice packs will eliminate the involuntary erection.

4. Is priapism always painful?

It depends upon type of Priapism, a Non-ischemic priapism is a painless, partially rigid, continuing and nonsexual sexual erection. Where as Ischemic priapism gives you a long painful erection.

Reference – American Urologist association