Priapism is an abnormal medical condition of the penis wherein the organ fails to return to a flaccid state while sustaining an irregularly prolonged erection within the span of four hours despite the absence of internal or external stimulation. Cases of priapism have been documented to be significantly painful, and are always considered as medical emergencies. While this medical condition may seem rare at first glance, it is important to note that there are thousands of documented cases concerning this condition that happen every year.
Priapism Causes & Treatment | Permanent Erection
Researches have said that more than $200 million are spent by hospitals every year to treat men suffering from various forms of priapism. It is also worth knowing that this condition can strike at all places and at all times, and that no human male with a well-functioning penis is immune to it. When priapism occurs, it’s always best to seek professional treatment from certified medical practitioners. There are numerous facets to this medical condition and treatment must always be undergone in a very thorough and comprehensive manner by qualified professionals. In most cases, when treated very early on and when treatments are done in a proper manner, it is highly probably for a patient to maintain full control of the penis once the medical condition has subsided.
Types Of Priapism:-
Priapism is a medical condition that can be classified in two very distinct ways, and as such, treatment for each particular case differs as well. Prior to treatment, it is first very important to distinguish the differences in the types of priapism and the degrees of the patient’s condition. These are the two types of priapism cases:
Low-flow Priapism or Ischemic priapism is the most common case of priapism among males; wherein it accounts for more than 80-90% of total documented cases of priapism. Low-flow Priapism cases are characterized to be as such when there isn’t adequate blood flow from the erect penis back into the rest of the human body.
High-Flow or Non-Ischemic Priapism is a rarer case of priapism wherein the vascular system partway along the penis is obstructed or compromised. While this case is uncommon, typically High-flow priapism cases are found to be painless and patients experience only minimal amounts of discomfort in contrast to Low-Flow Priapism cases.
Stuttering Priapism is also popularly known as intermittent priapism. This type of priapism is essentially a recurring form if ischemic priapism. This is the rarest of all types of priapism but is considered to be the most dangerous, and has the most potential to cause extreme discomfort to a patient.
Symptoms of Priapism:-
Symptoms of priapism may vary depending on the type of priapism that is present. The common denominator for both types of priapism cases is for a prolonged erection of the penis lasting for up to four hours despite the lack of required stimulation, whether brought about physically or psychologically. Some identifying symptoms of low-flow or ischemic priapism cases are having stiff penile shafts (with soft penis tips) and increasing penile pain. Symptoms for high-flow or non-ischemic priapism is having a fully erect, but not fully rigid penile shaft and having minimal pain or discomfort. One more blatant symptom of having non-ischemic priapism is having a penis with visible trauma or injuries on the exterior of the penile organ.
In order to determine the causes of priapism, there must first be an understanding of what brings about the prolonged erection that makes up the medical condition. A male’s penis becomes fully erect when influenced or manipulated by physical or psychological stimulation. The stimulation then proceeds to cause the penis’s blood vessels to expand and muscles to relax, hereby intensifying the blood flow to the soft tissues tissues of the penis. Under normal circumstances, when stimulation is ceded, the muscles and blood vessels will gradually return to their regular state hereby rendering the penis to be in a flaccid state.
When there are irregularities or discrepancies in the blood flow of the penis at the moment of erection or stimulation, that is when priapism occurs and an unusual erection is maintained despite the lack of stimulation. There are several conditions involving the mechanics of blood vessels, muscles, and soft tissues, all of which may contribute to cases of priapism.
Pre-existing blood conditions in human bodies are also likely suspects in bringing about priapism cases. Blood-related diseases like leukemia, anemia, and other hematologic dyscrasias have the capacities to trigger priapism cases in males. Another contributor to priapism cases include having glucose 6 phosphate dehydrogenase deficiency for this leads to decreased levels of NADPH, which may inevitably lead to cases of priapism.
Studies have also shown that various prescription drugs and medications may serve as probable causes for priapism. Most notably, drugs that are used to treat erectile dysfunction are possible culprits of priapism. Other drugs include antidepressants like buproprion and fluoexitine; alpha blockers like doxazosin, tamsulosin, and terazosin; anxiety and panic disorder medications like olanzapine, hydroxizine, clozapine, lithium, and risperidone; hormone supplements like testosterone; medications for attention-deficit disorder like atomoxetine; and blood thinners like heparin.
Low-flow or ischemic priapism can also be brought about by the consumption of alcohol or the use of marijuana, cocaine, and other forms of recreational drugs.
The most common cause for non-ischemic or high-flow priapism is blunt trauma or injury that is directly inflicted on the penile organ, the pelvis (or any area within the pelvic region), and the area between the anus and the penis.
Other factors that contribute to priapism include penis-related cancers, gout, amyloidosis, insect-bite infections, and neurogenic disorders. Insects like the black widow spider and the Brazilian wandering spider in particular possess bites that may directly cause cases of priapism in their victims.
When blood flow is stagnant and blood is trapped in the penis for prolonged periods of time, then those circumstances will end up depriving the tissues found in the penis of fresh oxygen. The lack of fresh oxygen throughout long stretches will lead to permanent tissue damage in the penis, and if left untreated, ultimately result in erectile dysfunction or penile disfigurement. In some extreme cases, untreated priapism also leads to the development of gangrene in the penis.
Due to the severity of the complications that can be brought about by prolonged cases of priapism, seeking professional medical assistance is absolutely vital. Various methodologies and tests must be undertaken immediately to gauge the status of the penile condition. The reason for such comprehensive testing is because treatment heavily relies on the parameters that are set by the results of these tests. Each case of priapism should be treated as special, and specialized diagnoses are the best way to go about treatment.
The usual first method of testing will be done through an examination of a patient’s medical history, particularly with details involving the penis. These examinations are conducted by questions about the patient’s lifestyle and a brief history of his medical conditions in the past. Also, the doctor may choose to perform visual examinations of the penis and the pelvic area.
The measurement of blood gas is also a common test that is performed on patients who suffer from priapism. This test is conducted by collecting a sample of blood directly from the patient’s penis via a needle insertion. The results of this test will most likely tell whether the priapism is low-flow or high-flow. The extraction of black blood indicates a deprivation of oxygen, and therefore implies a case of low-flow priapism. The extraction of red blood is an indication of high-flow priapism.
Another test involving the patient’s the blood has to do with the determination of red blood cell and white blood cell levels. The results of such tests may further reveal the presence of other blood-related diseases like anemia and leukemia.
One more example of a noninvasive test is a Doppler ultrasonography or an ultrasound. The ultrasounds may reveal the presence of structural irregularities in the penis that were brought about by injuries or trauma. This test is also used to measure the rate of blood flow within the penile organ.
Lastly, toxicology tests may also be an option for determining a patient’s diagnosis. Doctors might find it necessary to screen patients for any use of drugs that may have led to the priapism condition.
Treatments For Ischemic Priapism:-
There are various ways to go about treating ischemic priapism – the condition wherein blood flow is restricted within the penile organ. This form of priapism is always considered to be an emergency-level case, and must be treated swiftly and precisely. The most common way to begin treatment for ischemic priapism is by draining the penis of blood entirely and using medical remedies to compensate for the lack of healthy blood.
Blood is drained from the penis via an aspiration method with the use of a small needle and a syringe. Most commonly, this process is then followed up by the flushing of the penis with saline solution. What this method of treatment does is it seeks to alleviate the patient’s pain, and also removes the deoxygenated blood from the penis. In some cases, this method alone is enough to cause the erection to subside.
Another option for treatment is when medications are directly injected into the penis to combat the irregular blood flow and deoxygenated penis. Symphathomimetic medications like phenylephrine are injected into the organ in the hopes that they constrict the blood vessels that serve as passageways for blood to the penis. Once the constriction has taken shape, this may eventually lead to a forced opening up of exiting blood vessels to allow blood to leave the penis and make possible the return to regular blood flow. This method however will require further observation once concluded in cases of probable light headedness or raised blood pressure.
As a last resort, surgical procedures are also viable options for treatment. In this procedure, surgeons are typically tasked to redirect blood flow by manipulating the blood vessels in a manner that ensures proper bodily function.
Treatments For Non-Ischemic Priapism:-
Cases of non-ischemic or high-flow priapism are typically easier to treat compared to its counterpart. More often than not, cases of non-ischemic priapism go away even without treatment, letting the penile organ recover for itself. Most medical professionals will suggest a wait and observe approach to recovery for non-ischemic priapism patients. A common recommendation for relief and recovery is the placement of ice packs and some slight pressure on the area that covers the base of the penis and the rectum. This method of cold compression may also aid in ending the unwarranted erection.
In some very rare cases where the non-ischemic priapism was brought about by injuries or blunt traumas, surgery may be a required method of treatment. Typically, surgeries for non-ischemic priapism patients revolve around the insertion of absorbable gels that temporarily obstructs blood flow to the penis. The body ends up absorbing the gel after a set period of time. Damages to blood vessels and soft tissues within the penile organ as a result of trauma may also require surgical procedures to be corrected.
The prognosis of a patient greatly depends on various elements surrounding the condition of the patient. These elements include the duration and severity of the symptoms, the patient’s medical history, and the age of the patient.
A common concern for victims of priapism is the likelihood of potency or erectile dysfunction once the medical condition subsides. This all largely depends on the speediness of treatment and recovery. Studies have shown that over 92% of men retained potency when the condition was treated in less than 24 hours. However, 22% of men suffered from chronic erectile dysfunction when the condition was left untended for more than 7 days.
In some cases that involve trauma to the penile organ, infections may cause complications after the priapism has subsided. Any complications that were brought about by the condition to the structural integrity of the penile organ may leave room for future infections.
While there have been some recorded deaths of patients who were registered to have been experiencing priapism, these deaths weren’t necessarily brought about by the priapism per se, but by underlying blood diseases that were in relation to the priapism condition.
Priapism For Women:-
In relation to the medical condition of Priapism also known as Persistent Sexual Arousal Syndrome which only inflicts males, there is a female equivalent to this condition called clitoral priapism or clitorism. However, cases of clitoral priapism are extremely rare and aren’t necessarily considered to be medical emergencies the same way that male priapism cases are.