PRIAPISM

 Basic information

description

A persistent erection of the penis without sexual arousal or desire. It is an emergency condition that requires medical care to prevent complications. It can affect all ages, including children.

FREQUENT SIGNS & SYMPTOMS

A prolonged, usually painful erection. The erection may last hours to days.

causes

• It may be associated with certain diseases or use of drugs. Sometimes, no cause is found. Two types occur:
  • Low-flow—blood becomes trapped in the penis causing its engorgement.
  • High-flow (rarer)—occurs when the blood in the penis does not circulate properly. It is usually due to an injury.

risk increases with

• Drugs that are used to treat impotence.
• Blood disease (sickle-cell disease or thalassemia).
• Cancer (leukemia or multiple myeloma).
• Certain drugs used to treat other disorders (such as chlorpromazine, prazosin, trazodone, some corticosteroids, anticoagulants, and antihypertensives).
• Spinal tumor, injury, or anesthesia.
• Carbon monoxide poisoning.
• Black widow spider bite.
• Malaria.
• Cocaine, marijuana, ecstasy, and alcohol abuse.
• Use of anabolic steroids.
• Prolonged sexual activity.
• Tumors or blood clots in the pelvis.
• Nervous system disorders (e.g., multiple sclerosis).

PREVENTIVE MEASURES

No specific preventive measures. Avoid risk factors where possible.

expected outcomes

With prompt medical care, the outcome is good. Delayed treatment can lead to increased risk of erectile dysfunction.

possible complications

• Impotence.
• Recurrence of priapism.
• Infection.
• Complications from surgical procedures may occur.

 diagnosis & treatment

general measures

• Emergency treatment is necessary because of the risk of permanent damage to the penis. Your health care provider will do a physical exam and an exam of the penis. Questions will be asked about your symptoms, activities, and drug use. Medical tests may include a small amount of blood taken from the penis for study. Ultrasound or angiogram (special type of x-ray) tests may be done.
• Treatment may include drug therapy, aspiration of the blood, or surgery. Any underlying cause will also need treatment. Patients with sickle-cell disease may need a blood transfusion. Spinal anesthesia is sometimes helpful.
• As a temporary measure, ice packs may be applied to the penis and perineum to help reduce swelling. Walking up a flight of stairs may help divert blood flow.
• Aspiration involves using a needle to remove blood from the penis. This will reduce pressure and swelling.
• Surgery may be needed if other treatment measures are not effective. A shunt (passageway) may be inserted to divert the blood flow. In high-flow priapism, surgery may be done to tie off an injured artery to restore normal blood flow.

medications

• One or more drugs may be used in the treatment of priapism.
• If a drug you take is the cause of priapism, it may be discontinued. An alternative drug may be prescribed.

activity

Rest until erection is relieved.

diet

No special diet.

 notify our office if

You or a family member has an erection that persists for no apparent reason. Do not waste time trying to get it down with cold compresses. Go immediately to an emergency room.

Special Notes: