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Dr. Reynolds
Priapism is a prolonged and usually painful erection of the penis. The erection may continue hours beyond sexual arousal, or it may not be caused by sexual stimulation at all. Dr. Jerman, can you tell us more about priapism?
Dr. Jerman
Sure, Dr. Reynolds. There are two main types of priapism: ischemic and nonischemic.
Ischemic priapism, also called low-flow priapism, is the more common type. It results from blood not being able to leave the penis. Blood-related diseases, such as sickle cell anemia and leukemia, or certain medications may contribute to ischemic priapism. Signs and symptoms of ischemic priapism include:
- A rigid penile shaft, but the tip of the penis is soft, and
- Progressive penile pain
Men who have an erection lasting more than four hours should seek immediate medical care. Blood trapped in the penis for too long becomes oxygen-deprived, which can damage or destroy tissues in the penis. This can result in erectile dysfunction.
Treatment for ischemic priapism usually begins with a combination of draining blood from the penis and using medications. If these treatments are unsuccessful, surgery may be recommended to reroute blood flow so that blood can move through the penis normally.
Nonischemic priapism, also known as high-flow priapism, occurs when blood flow in the penis isn't regulated appropriately. A common cause of nonischemic priapism is trauma or injury to the penis, pelvis, or perineum. Unlike ischemic priapism, this type is usually painless, and the penile shaft is erect but not fully rigid.
Nonischemic priapism often goes away with no treatment. Providers may recommend applying ice packs and pressure to the perineum to help end the erection. Surgery may be necessary to repair arteries or tissue damage if priapism is caused by a serious injury.