What is Priapism? Causes, Symptoms, and Urgent Treatment Options
A prolonged erection that lasts more than four hours and occurs without sexual stimulation is more than uncomfortable; it’s a medical emergency known as priapism. If left untreated, priapism can lead to tissue damage, erectile dysfunction, and permanent loss of normal erectile function. This article breaks down everything you need to know, from causes and symptoms to treatment and prevention.
At Urology of Greater Atlanta, all our physicians are board-certified, offering expert care for penile emergencies, including priapism. With multiple locations throughout Georgia, we’re here to provide prompt treatment and help restore your normal blood flow and erectile function. Contact us today for compassionate and specialized urological care.
What is Priapism?
Priapism is a prolonged and often painful erection of the penis that lasts more than four hours and is not related to sexual stimulation. It occurs when blood becomes trapped in the erectile tissue of the penis (specifically the corpora cavernosa), disrupting normal blood flow.
Because priapism can result in permanent tissue damage and erectile dysfunction, it requires immediate treatment to avoid long-term complications.
What Are the Types of Priapism?
There are three main types of priapism, each with distinct characteristics:
- Ischemic Priapism (Low Flow Priapism): The most common and dangerous type, caused by trapped blood that doesn’t drain from the penis. It is typically painful and requires urgent treatment.
- Non-Ischemic Priapism (High Flow Priapism): Usually results from a ruptured artery due to trauma (such as a spinal cord injury), allowing oxygenated blood to flow uncontrollably into the penis. This type is less painful and not an emergency.
- Stuttering Priapism: A recurrent form of ischemic priapism, often seen in individuals with sickle cell disease or other blood disorders.
What Are the Causes of Priapism?
Priapism occurs due to various conditions or external factors that interfere with normal blood flow, such as:
- Sickle cell disease: A leading cause in children and adolescents due to blocked blood flow.
- Other blood disorders: Including leukemia or thalassemia.
- Medications: Especially those used to treat erectile dysfunction, like PDE5 inhibitors.
- Recreational drugs: Cocaine, marijuana, and alcohol can contribute.
- Blood thinners: These may interfere with normal clotting and flow.
- Injury: Spinal cord injury or trauma to the genitals.
If you have had a medical history of prior priapism or penile conditions, then you are likely to get it again.
What Are the Symptoms of Priapism?
Recognizing the signs of priapism can save your erectile tissue from lasting damage. Symptoms include:
- An erection lasting more than four hours
- A painful erection (especially in low-flow priapism)
- Hard penile shaft with a soft tip (in ischemic priapism)
- Little to no sexual arousal
- Recurring, unwanted erections (stuttering priapism)
What Are the Complications of Priapism?
If priapism is left untreated, it can cause:
- Permanent erectile dysfunction
- Tissue damage due to a lack of oxygenated blood
- Scarring of the penile tissues
- In severe cases, penile deformity or the need for prosthetic surgery
These complications underline the importance of prompt treatment.
How is Priapism Diagnosed?
To accurately diagnose priapism, a doctor will:
- Review your medical history and symptoms
- Conduct a physical exam
- Order blood tests to check for blood disorders
- Perform a penile blood gas analysis to determine if the blood is oxygenated
- Use ultrasound to assess blood flow and check for ruptured arteries
How Do You Treat Priapism?
Treatment for priapism depends on the type and severity:
For Ischemic Priapism:
- Aspiration to remove trapped blood
- Injection of medications to constrict blood vessels
- Surgical shunt to allow trapped blood to return to normal circulation
For Non-Ischemic Priapism:
- Monitoring without intervention if symptoms are mild
- Ice packs to reduce swelling and slow blood flow
- Surgical ligation of the artery if necessary
For Stuttering Priapism:
- Hormonal therapy or medications to prevent recurrence
- Treating the underlying cause, such as sickle cell
Can Priapism Be Prevented?
While not all cases are preventable, you can reduce risk by:
- Managing chronic conditions like sickle cell disease
- Avoiding recreational drugs
- Only using medications to treat erectile dysfunction under medical supervision
- Regular checkups to monitor blood disorders
Patients with a history of stuttering priapism may be prescribed long-term medications to prevent episodes.
Get Help Fast: Contact Urology of Greater Atlanta
If you’re experiencing a prolonged erection or any signs of priapism, don’t wait. Prompt treatment can mean the difference between a full recovery and permanent damage. At Urology of Greater Atlanta, our board-certified urologists are experienced in treating all types of priapism and penile emergencies.
Find us at multiple convenient locations across Georgia.
Call today to schedule an urgent consultation or visit our website to learn more about how we can help you restore normal blood flow and protect your erectile function.
