Living with Priapism: Causes, Types, Symptoms, & Treatment Options

Priapism is a prolonged and potentially painful erection of the penis that can happen without sexual stimulation or arousal. It causes blood in the penis to become trapped and unable to drain through the penile arteries.

It is often unrelated to or continues long beyond sexual activity. It can be a serious condition due to the risk of permanent tissue damage. Priapism is a medical emergency that requires immediate attention. If it’s allowed to persist, it can lead to scarring of the penis and potentially erectile dysfunction.

Diagnosing priapism usually starts with a detailed medical history and physical exam. Healthcare providers look at the genitals and groin to determine the pattern of rigidity and the occurrence of trauma.

Sometimes, diagnostic testing is ordered to gain more information. The procedure for this is as follows:

• A sample of blood is taken from the penis
• If the blood is black, it indicates ischemic priapism
• If the blood is bright red, it is probably a non-ischemic priapism.

A doctor may also order:

• Blood tests
• Ultrasounds
• Urine toxicology

As well as deciding the presence of priapism, these tests determine what may be causing the condition.

Causes of Priapism:

• Medications:Some medications can affect nerves in the body, including in the penis, these nerves widen the arteries that supply the penis, allowing it to become engorged and erect.
• Drugs: Use of some recreational drugs is associated with priapism, including crystal meth, marijuana, cocaine, and ecstasy. Drugs: Use of some recreational drugs is associated with priapism, including crystal meth, marijuana, cocaine, and ecstasy.
• Injury: Damage to the penile artery can occur with an injury to the penis or perineum and can prevent blood from circulating or draining. This is a common cause of non-ischemic priapism.
• Sickle cell anemia: Abnormally shaped red blood cells can cause blockage of the penile artery and, lead to, priapism. Approximately 42 percent of adults with sickle-cell anemia will eventually develop priapism.
• Cancers: In rare cases, priapism can occur with certain types of cancerous growths, especially if they impede on the penile artery or nerve supply and cause blockages.
• Blood disorders: Some blood conditions can cause priapism. Thalassemia, chronic leukemia, and multiple myeloma, in particular, have been associated with priapism.

Types of Priapism:

• Ischemic: Also known as low-flow priapism, it occurs when blood is not able to leave the penis after an erection. Most cases of priapism are ischemic.
• Recurrent: This is a type of ischemic priapism also called recurrent or stuttering priapism. It is uncommon and usually seen in men with sickle cell anemia.
• Non-ischemic:Also known as high-flow priapism, this type is caused by poorly regulated blood flow in the penis.

Symptoms
The primary symptom of priapism is a prolonged erection. Other symptoms depend on the type of priapism that is occurring.

Symptoms of ischemic priapism include:

• Penile pain that gets worse with time.
• An erection where the tip of the penis remains soft.

While non-ischemic priapism is usually painless and causes an erection that is not fully rigid.

Treatment of priapism depends on the type and the cause. A professional healthcare provider will evaluate and decide whether it is ischemic or non-ischemic and the likely cause.