Priapism is a persistent, painful erection that lasts for more than four hours and is unrelated to sexual arousal. It’s a true, believe it or not, urological emergency that requires immediate medical attention. It is not something to ignore or “wait out,” as delays in treatment can lead to permanent damage to the penis, including erectile dysfunction (ED).
Types of Preapism
While all priapism is serious, it’s categorized into two main types:
Ischemic (Low-Flow) Priapism: The most common and dangerous type. It occurs when blood gets trapped in the erection chambers of the penis. Because the trapped blood is not getting oxygenated, it can cause tissue damage. It is usually painful, and the penis is typically rigid in the shaft but often softer at the head.
Non-Ischemic (High-Flow) Priapism: This is rarer and less urgent than the low-flow type. It usually results from trauma to the groin, which causes an artery to rupture and lead to unregulated blood flow into the penis. The erection is usually less painful, and the penis is not completely rigid.
Who is at Risk?
While priapism can happen to anyone, certain factors significantly increase the risk. If you fall into these categories, it’s crucial to be aware and discuss proactive steps with a doctor:
Sickle Cell Disease: This is the most common cause in men. The sickle-shaped red blood cells can block blood flow, leading to ischemic priapism. Patients with SCD should follow their prescribed treatment plans closely.
Medications: A variety of drugs can potentially trigger priapism, including certain antidepressants, medications for erectile dysfunction, blood thinners, and some antipsychotics.
A cautionary measure would be to never exceed the prescribed dosage for ED medications.
Injectable ED Treatments: Medications injected directly into the penis to induce an erection carry a risk. Patients must be carefully trained on the correct dosage and technique. Therefore, it is important to involve your partner or someone close to you in the training.
Recreational Drugs: The use of illicit drugs, particularly cocaine and marijuana, has been linked to cases of priapism. Abstinence is the only sure prevention.
Cautionary Measures
The critical takeaway is the 4-hour rule. If you experience a painful, persistent erection:
Note the Time: Keep track of exactly when the erection started.
Immediate Action: If it’s been less than 4 hours, you are advised to try mild, temporary, at-home measures only if instructed by a doctor in the past, such as light exercise or applying a cold compress to the perineum. However, this should not deter you from seeking professional help.
Seek Emergency Care: If the erection has lasted 4 hours or longer, you must go to the Emergency Room (ER) immediately. Do not be embarrassed. This is a medical emergency that could save your sexual function.
Remember, priapism is a serious condition, but rapid action can significantly improve the outcome and prevent long-term complications like permanent ED. When in doubt, always seek medical advice.
Also Read: Improving Male Fertility: What Really Works
