Priapism is characterized by painful and persistent erections that occur unrelated to sexual stimulation. Here's a straightforward explanation of its causes, symptoms, diagnosis, treatment, and prevention:
A variety of factors can contribute to priapism, including:
As a result of ischemic (low-flow) priapism, blood becomes trapped in the penis and cannot flow out, resulting in oxygen deprivation and tissue damage. Often, it is associated with conditions such as sickle cell disease, leukemia, certain medications (e.g., antipsychotics, erectile dysfunction drugs), or spinal cord injuries.
Non-ischemic (High-Flow) Priapism: Caused by an injury to the penis or perineum, this type of priapism is usually less painful and may resolve spontaneously.
There are several symptoms of priapism, including:
An erection lasting more than four hours that is painful and persistent
Penis swelling and tenderness
Urination difficulties or blood in the urine
A feeling of fatigue or lightheadedness (in cases of prolonged priapism)
In order to diagnose priapism, a healthcare provider conducts a physical examination and reviews the patient's medical history. Blood tests may also be performed to determine underlying causes such as sickle cell disease or leukemia. It is possible to distinguish between ischemic and non-ischemic priapism using imaging studies such as ultrasound.
The treatment for priapism depends on the type and underlying cause, but typically involves:
In order to prevent tissue damage and erectile dysfunction, it is essential to treat ischemic priapism immediately. The penis can be relieved by aspirating or draining blood, by injecting medications (e.g., phenylephrine) to constrict blood vessels, or by surgery in severe cases.
When non-ischemic priapism persists or causes complications, embolization (blocking blood flow to the penis) or surgery may be required.
Managing underlying conditions and avoiding triggers, such as medication or trauma to the penis, are essential to preventing priapism. If priapism occurs in sickle cell disease patients, they should seek prompt medical attention. Healthcare providers should discuss alternative treatments with patients taking medications associated with priapism.
