Priapism: Prolonged erection
Priapism: Prolonged erection
Priapism is a prolonged erection of the penis. The unwanted, persistent erection isn't caused by sexual stimulation or arousal, and priapism is usually painful.
Priapism is an uncommon condition that needs immediate medical attention. Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction).
Priapism is most common between ages 5 and 10 in boys and ages 20 and 50 in men.
Priapism causes abnormally persistent erections not related to sexual stimulation. Priapism symptoms may vary depending on the type of priapism. There are two main types: ischemic and nonischemic priapism.
When to see a doctor
An erection normally occurs in response to physical or psychological stimulation. This stimulation causes certain blood vessels to relax and expand, increasing blood flow to spongy tissues in the penis. Consequently, the blood-filled penis becomes erect. After stimulation ends, the blood flows out, and the penis returns to its nonrigid (flaccid) state.
Priapism occurs when some part of this system — the blood, blood vessels or nerves — changes normal blood flow. Subsequently, an unwanted erection persists. Factors that can contribute to priapism include the following.
Sickle cell anemia is the most common cause of priapism in boys. Sickle cell anemia is an inherited disorder characterized by abnormally shaped red blood cells. These abnormally shaped cells can block the flow of blood.
Alcohol and drug use
In some cases, doctors are unable to identify the specific cause for priapism.
Ischemic priapism can cause serious complications. The blood trapped in the penis is deprived of oxygen. When an erection lasts for longer than four hours, this oxygen-poor blood can begin to damage or destroy tissues in the penis. As a result, untreated priapism may cause:
Preparing for your appointment
If you or your child has experienced a painful, persistent erection that lasted less than four hours, or multiple unwanted, persistent erections (stuttering priapism), see your primary care doctor. If the erection has lasted more than four hours, go to the emergency room.
Your doctor or the emergency room doctor may suggest that you make a follow-up appointment with a specialist in reproductive and urinary organs (urologist).
If you have time before you see your doctor, it's a good idea to prepare for questions the doctor is likely to ask.
What you can do
You may also want to prepare a list of questions to ask the doctor:
If other questions occur to you or you don't understand something, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Your doctor may also order laboratory tests to determine if a disease or condition is causing priapism.
What you can do in the meantime
Tests and diagnosis
If you have an erection lasting more than four hours, you need emergency care. The emergency room doctor will determine first whether you have ischemic priapism or nonischemic priapism. This is necessary because the treatment for each is different, and treatment for ischemic priapism needs to be done as soon as possible.
Medical history and exam
Treatments and drugs
Surgery may be necessary in some cases to insert material that temporarily blocks blood flow to the penis. The body eventually absorbs the material. Surgery may also be necessary to repair arteries or tissue damage resulting from an injury.
Depending on the probable cause of the priapism, steps to prevent recurrent priapism may include:
Last Updated: 2013-06-15
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