Priapism

21:55 - 4 May , 2021

Disease

What is Priapism?

It is a pathology in which the penis remains erect for several hours or even days, without physical or psychological sexual stimulation, resulting in pain. It occurs most often in men between the ages of 25 and 50, and boys between the ages of 4 and 12 with sickle cell disease. The appearance of this condition may be due to the following factors:
  • Sickle cell disease.
  • Inflammation of the urethra
  • Leukemia or other blood disorders.
  • Alcoholism.
  • Drug addiction.
  • Intake of antidepressants, hypertension, or erectile dysfunction medication.
  • Metabolic disorders.
  • Spinal or nerve injuries.
  • Certain types of cancer that affect the penis.
This condition is usually classified into:
  • Ischemic: it is the most frequent and occurs when blood remains accumulated in the penis due to dysfunctions in the penile muscles or due to vascular problems. It must be treated promptly due to the lack of oxygen, which can have serious consequences.
  • Non-ischemic: penis vascularization has an anomaly caused by blows or injuries.

Symptoms

Symptoms vary according to the type of priapism in question, but the characteristic signs consist of:
  • Stiffness in the penis, but with a soft glans.
  • Sore penis, whose intensity increases over time.
  • Penis erect for more than four hours without physical or psychological sexual stimulation.
Sometimes unwanted and painful erections occur and last a short time, then become more frequent and lasting longer. When an erection lasts for many hours, it is necessary to see your doctor immediately to avoid serious complications and prevent injury to the penile tissue that causes erectile dysfunction.

Diagnosis and treatment

Once your doctor analyzes your symptoms and your medical history, they will perform a physical examination of your genitals, abdomen, groin, and perineum, to determine the type of priapism you have, for which they may require a series of tests to confirm the diagnosis, such as:
  • Blood and laboratory tests: to help detect the presence of cancer, sickle cell disease, or other blood disorders.
  • Identification and measurement of gases in the penis’ blood: to determine the type of priapism in question.
  • Ultrasound: to measure blood flow inside the penis or observe any injury or abnormality in it.
  • Toxicological studies: to determine if any medication is responsible for the condition.
The treatment to be followed will depend on the type of priapism you suffer from. If it is ischemic, the doctor will drain the blood from the penis with the help of a syringe and will administer medications that dilate the blood vessels to facilitate drainage. If this doesn't work, you may need to have surgery to drain the oxygen-depleted blood and restore blood flow. In the case of nonischemic priapism, the erection will go away without the need for treatment. Besides, there is no risk of damaging the penis. The doctor may suggest the application of ice compressing the perineum to reverse the erection. If you have sickle cell disorder, you'll need additional treatment for sickle cell disease in addition to what you receive for priapism. At ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • mayoclinic.org
  • medlineplus.gov
  • msdmanuals.com
  • topdoctors.es
  • fesemi.org
  • medigraphic.com
  • De Miguel-Ibáñez R, Sánchez-González MD, Herrera-Madrid DA. Priapismo como manifestación inicial de leucemia mieloide crónica, una manifestación poco frecuente. Rev Hematol Mex. 2021;22(2):121-126.
  • Roque GW. Priapismo en la drepanocitosis. Diagnóstico y opciones terapéuticas. Rev Cubana Hematol Inmunol Hemoter . 2017;33(3):15-23.
  • Carrillo-Córdova LD, Acevedo-García C, Rivera-Astorga H, et al. Priapismo: comorbilidades, tratamiento, complicaciones y función sexual de los pacientes. Rev Mex Urol. 2017;77(5):383-388.
  • Castro MO, Meléndez BJE, Pedro SIE, et al. Caracterización epidemiológica, diagnóstica y terapéutica de pacientes con priapismo. MediSan. 2015;19(10):1238-1247.

						
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