priapism – what is it?

Priapism is a pathological condition characterized by prolonged erection in a man without sexual arousal. Priapism is caused by a violation of blood circulation in the penis.

This pathology was named after the ancient Greek god of fertility, who was depicted with a permanently erect penis.

The ability to maintain an erection for a long time is considered a sign of masculine strength, but in the case of priapism, this is an excruciating condition, sometimes accompanied by severe pain and having serious negative consequences.

 

Types of priapism

Priapism in men can have different mechanisms of development, manifestations and methods of treatment.

Arterial priapism

It occurs due to excessive blood flow to the corpora cavernosa of the penis. The blood builds up, causing an erection. Painful sensations, as a rule, do not arise.

Ischemic priapism

It is veno-occlusive. This pathology is associated with poor outflow of venous blood in the penis due to its high viscosity or the formation of blood clots. An erection is accompanied by pain. The most severe form of priapism, which can cause serious complications.

Nocturnal priapism

It is also called pseudopriapism, chronic priapism. It is characterized by the fact that a man has involuntary prolonged nocturnal erections, accompanied by pain and heaviness in the perineum. As a result, he wakes up and cannot sleep for a long time. Such attacks can occur several times during the night and even during daytime sleep.

It is known that a normal healthy man has short-term erections during the night, which, unlike nocturnal priapism, do not cause awakening and do not in any way affect his health and well-being.

 

Causes of priapism

In the medical literature, there are about fifty reasons that can lead to priapism. The main ones are:

• blood diseases (leukemia, thalassemia, sickle cell anemia);
• trauma to the penis and perineum;
• injuries and trauma to the spine;
• malignant tumors;
• intoxication;
• some medications (psychostimulants, antidepressants) drugs that increase potency, especially if they are administered by injection.

Priapism manifestations

1. Prolonged erection in men occurs without sexual arousal.
2. Orgasm and ejaculation are absent.
3. An erection lasts a long time, sometimes several hours.
4. The shaft of the penis is hard, but the glans remains soft.
5. The head of the penis bends towards the abdomen.
6. There are pains in the area of the root of the penis, radiating to the perineum (in the case of ischemic form).
7. The penis turns red, then cyanosis develops.
8. Urination is not disturbed, but the stream goes up.

Treatment

For an acute attack at home, you can try applying cold to the groin area. Sometimes an erection goes away after a little exercise. If this does not help, you should go to the hospital. And here the time factor is very important.

An abnormal erection that lasts more than 4 hours and is accompanied by pain (ischemic priapism) is a medical emergency. Serious complications are possible if action is not taken within 6 hours.

In the hospital, cold is used to relieve an acute attack and restore blood circulation, drugs are injected into the penis to help normalize blood flow, and blood is removed from the penis with a needle (aspiration).

If these measures do not help, they perform an operation – they drain excess blood from the penis into a vein.

With the onset of irreversible changes in the penis, falloprosthetics is recommended.

Arterial priapism is not a medical emergency and is often treated conservatively.

Attacks of nocturnal priapism are usually relieved by cold or urination.

Men with priapism are advised to consult a urologist-andrologist, be examined and identify the cause of the pathology.

Consequences of priapism

Prolonged, more than 6 hours, disturbance of blood flow in the penis causes irreversible changes in its tissues.

An early complication of priapism is acute cavernitis – inflammation of the corpora cavernosa.

Later may appear:

• shortening of the penis;
• cavernous fibrosis – replacement of the tissue of the corpora cavernosa with connective tissue – and as a result, erectile dysfunction.

In this case, to restore potency after priapism, falloprosthetics will have to be performed.