What Is Priapism?

Priapism is a condition in which a man experiences a prolonged erection. This prolonged erection usually lasts for four hours or more. The condition is not caused by sexual stimulation or arousal. It is usually painful as well. Priapism is most common between ages 5 and 10 years old in boys and ages 20 and 50 years old in men. It is estimated that up to 89 percent of adults and 27 percent of children with sickle cell disease have priapism.

The signs and symptoms of priapism may vary depending on the type of priapism a man has. There are two main types of priapsim: ischemic priapsim and nonischemic priapism. Ischemic priapism is also known as low-flow priapism. It is caused by blood being unable to leave the penis. This type of priapism is the most common type of priapism. The signs and symptoms of ischemic priapism may include an unwanted erection that lasts for more than four hours, an unwanted erection that occurs off and on for several hours (also known as stuttering priapism), a rigid penile shaft (but usually soft tip of penis, or glans, and usually a painful or tender penis. Nonischemic priapism is also known as a high-flow priapism. Nonischemic priapism occurs when there is too much blood flow into the penis. This type of priapism is usually painless. The signs and symptoms of nonischemic priapism may include an unwanted erection that lasts for at least four hours, and an erect (but not rigid) penile shaft.

The risk factors that may increase a male’s risk for developing priapism include:

·       Age (Most common in males between the ages of 5 and 10 years old and 20 and 50 years old if you don't have sickle cell disease, and 19 and 21 years old if you do)

·       Taking some medications for depression, mental illness, or high blood pressure

·       Drinking alcohol or using drugs like cocaine or marijuana

·       Blood disorders such as sickle cell disease, leukemia, thallasemia, or multiple myeloma

·       Trauma to the genital area or acute spinal cord injury

·       Penile injection therapy for erectile dysfunction

·       Platelet disorders such as thrombotic thrombocytopenia purpura

Ischemic priapism is an emergent medical situation that requires immediate attention and treatment. The initial treatment for this condition involves draining the blood from the penis and using medications. Other treatment options may include surgery, aspiration, embolization, treating underlying conditions, a surgical shunt, surgical litigation, and an intracavernous injection.