Priapism
What is it?
Priapism is the medical term for a persistent erection, (at least 4 hours) which is usually painful, and may not be related to sexual stimulation or activity. During a normal erection, blood flows into the penis and is kept there because the veins (which return blood to the heart) become compressed by the swollen muscles in the penis. After ejaculation (the release of semen from the end of the penis), hormones make the arteries get narrower, which releases the pressure on the veins, so that the blood can drain out again.
Priapism can happen for no known reason, (35% of cases) or as a result of medical treatment, for example, injection therapy for impotence/erectile dysfunction. Other causes include trauma, medications (e.g. for high blood pressure, psychiatric problems), alcohol abuse, or an underlying blood or nervous system disorder, for example, leukaemia, sickle-cell anaemia or spinal cord injury.
What are the symptoms?
The main, and most obvious, symptom, is an erection that will not go away. If you have had an erection for more than four hours, you should get medical help – either your GP or the Accident and Emergency department of your local hospital – whichever is quicker. In rare cases, if the erection is left for too long, severe damage to the tissues in the penis can result. This may affect future erections. It is therefore very important to seek medical help as soon as possible.
How is it diagnosed?
Although the doctor will be able to see your problem immediately, it will be important to try and find out the reason why it has occurred. Your doctor will take a detailed history from you and will want to know if priapism has ever happened to you before. You will also have a physical examination so that the doctor can see if there has been any trauma to the penis. If the underlying cause cannot be found, the doctor may give you a blood and urine test to check for any underlying medical conditions.
What is the treatment?
Many cases get better on their own after repeated ejaculation, or physical activity such as a brisk walk. However, if these measures do not work, then the doctor may try one of several methods, for example, blood may be removed from your penis through a needle. If this method does not work, another medication, which works like a reversing agent, may be injected into the penis. In very rare cases, surgery may be needed to avoid permanent damage to the tissues of the penis.
Further information
Your local GP surgery is the best place for you to find information on priapism, especially if you have specific concerns about your symptoms or treatment. Charities can also be useful sources of information and support.
Men's Health Forum www.malehealth.co.uk
