Priaprism | definition of Priaprism by Medical dictionary Priaprism | definition of Priaprism by Medical dictionary Priapism is a rare condition that causes a persistent, and often painful, penile erection. Description Priapism is drug induced, injury related, or caused by disease, not sexual desire. As in a normal erection, the penis fills with blood and becomes erect. However, unlike a normal erection that dissipates after sexual activity ends, the persistent erection caused by priapism is maintained because the blood in the penile shaft does not drain. The shaft remains hard, while the tip of the penis is soft. If it is not relieved promptly, priapism can lead to permanent scarring of the penis and inability to have a normal erection. Causes and symptoms Priapism is caused by leukemia, sickle cell disease , or spinal cord injury . It has also been associated as a rare side effect to trazodone (Desyrel), a drug prescribed to treat depression. An overdose of self-injected chemicals to counteract impotence has also been responsible for priapism.

The chemicals are directly injected into the penis, and at least a quarter of all men who have used this method of treatment for over three months develop priapism. Diagnosis A physical examination is needed to diagnose priapism. Further testing, including nuclear scanning or Doppler ultrasound, will diagnose the underlying cause of the condition. Treatment There are three methods of treatment. The most effective is the injection of medicines into the penis that allow the blood to escape. Cold packs may also be applied to alleviate the condition, but this method becomes ineffective after about eight hours. For the most serious cases and those that do not respond to the first two treatments, a needle can be used to remove the blood. The tissues may need to be flushed with saline or diluted medications by the same needle method. That failing, there are more extensive surgical procedures available. One of them shuts off much of the blood supply to the penis so that it can relax. If the problem is due to a sickle cell crisis, treatment of the crisis with oxygen or transfusion may suffice. Prognosis If priapism is relieved within the first 12-24 hours, there is usually no residual damage.

After that, permanent impotence may result, since the high pressure in the penis compromises blood flow and leads to tissue death (infarction). Prevention An antineoplastic drug (hydroxyurea) may prevent future episodes of priapism for patients with sickle cell disease. Resources Wertheimer, Neil. Total Health for Men. Emmaus, PA: Rodale Press, 1995. Periodicals Werthman, P., and J. Rajfer. "MUSE Therapy: Preliminary Clinical Observations." Urology 50 (November 1997): 809-811. Key terms Antineoplastic — A drug used to inhibit the growth and spread of cancerous cells. Doppler ultrasound — An imaging technique using ultrasound that can detect moving liquids. Infarction — Death of tissue due to inadequate blood supply. Nuclear scanning — Use of injected radioactive elements to analyze blood flow. Sickle cell anemia — A hereditary abnormality of blood cells in which some are deformed and may plug up small blood vessels. priapism [pri´ah-pizm] persistent abnormal erection of the penis, accompanied by pain and tenderness.

It is seen in diseases and injuries of the spinal cord, and may be caused by vesical calculus and certain injuries to the penis. pri·a·pism (prī'ă-pizm), Persistent erection of the penis, accompanied by pain and tenderness, resulting from a pathologic condition rather than sexual desire; a term loosely used as a synonym for satyriasis. [see priapus] /pri·a·pism/ (pri´ah-pizm) persistent abnormal erection of penis, accompanied by pain and tenderness. priapism (prī′ə-pĭz′əm) n. Persistent, usually painful erection of the penis, especially as a consequence of disease and not related to sexual arousal. priapism [prī′əpiz′əm] Etymology: Gk, priapos, phallus an abnormal condition of prolonged or constant penile erection, often painful and seldom associated with sexual arousal. It may result from localized infection, a lesion in the penis or the central nervous system, or the use of medications or recreational drugs such as cocaine. It sometimes occurs in men who have acute leukemia or sickle cell anemia.

Priapism priapism A rare urologic emergency characterised by painful erection without sexual excitement or desire, in which the penis does not return to its flaccid state—despite the absence of both physical and psychological stimulation—within four hours; 60% are idiopathic, the rest are due to various disorders, such as leukaemia, pelvic infection, pelvic cancer, sickle cell anaemia, abuse substances (alcohol, cocaine, marijuana, methaqualone), drugs (anticoagulants, antihypertensives, corticosteroids, neuroleptics, tolbutamide, papaverine), scorpion bites and penile or spinal cord trauma. Clinical findings Painful, prolonged erection with a tense, congested corpora cavernosa. Accumulation of high-viscosity hypoxic blood in corpora cavernosa secondary to obstruction of venous blood. Prognosis Without decompression, interstitial oedema and fibrosis of the spongiosa of the penile shaft ensue, causing permanent impotence.

priapism Urology A urologic emergency characterized by painful erection without sexual excitement or desire; 60% are idiopathic, the rest are due to various disorders–eg, leukemia, pelvic infection, pelvic CA, sickle cell anemia, abuse substances–alcohol, cocaine, marijuana, methaqualone, drugs–anticoagulants, antihypertensives, corticosteroids, neuroleptics, tolbutamide, papaverine, scorpion bites, penile or spinal cord trauma Clinical Painful, prolonged erection with a tense, congested corpora cavernosa Prognosis Without decompression, interstitial edema and fibrosis of penile shaft ensue, causing impotence. See Bobbittize, Penile prosthesis , Peyronie's disease . pri·a·pism (prī'ă-pizm) Persistent erection of the penis, accompanied by pain and tenderness, resulting from a pathologic condition rather than sexual desire. priapism Persistent, usually painful erection of the corpora cavernosa of the penis without sexual interest. Priapism results from the failure of blood to drain from the penis and may lead to permanent damage from blood clotting.

Urgent treatment is needed to withdraw the blood through a wide-bore needle or to obtain detumescence by other means. From the Greek Priapos , the god of procreation. priapism persistent abnormal erection of the penis, accompanied by pain and tenderness. It is seen in diseases and injuries of the spinal cord, and may be caused by vesical calculus and certain injuries to the penis. Priapism - MediGoo - Health Tests and Free Medical Information Priapism Description, Causes and Risk Factors: Persistent erection of the penis, accompanied by pain and tenderness, resulting from a pathologic condition rather than sexual desire; a term loosely used as a synonym for satyriasis. Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction. An erection normally occurs in response to physical or psychological stimulation. This stimulation causes certain blood vessels to relax and expand, increasing blood flow to spongy tissues in the penis. Consequently, the blood-filled penis becomes erect.

After stimulation ends, the blood flows out, and the penis returns to its nonrigid (flaccid) state. Priapism occurs when some part of this system — the blood, blood vessels or nerves — changes normal blood flow. Subsequently, an unwanted erection persists. Factors that can contribute to priapism include the following: It can occur in all age groups, including newborns. However, it usually affects men between the ages of 5 to 10 years and 20 to 50 years. There are two categories of priapism: low-flow and high-flow. Low-flow: This type of priapism is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but also affects men with sickle-cell disease, leukemia (cancer of the blood) or malaria. High-flow: High-flow priapism is more rare than low-flow and usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally. Risk Factors: Trauma to the spinal cord or to the genital area.

Black widow spider bites. Illicit drug use, such as marijuana and cocaine. Symptoms: Unwanted erection lasting more than four hours. Rigid penile shaft, but usually soft tip of penis (glans). Erection not related to sexual stimulation or persistent after stimulation. Usually painful or tender penis. Diagnosis: If you experience priapism, it is important that you seek medical care immediately. Tell your doctor: The length of time you have had the erection. How long your erection usually lasts. Any medication or drugs, legal or illegal, which you have used. Be honest with your doctor - illegal drug use is particularly relevant since both marijuana and cocaine have been linked to priapism. Whether or not priapism followed trauma to that area of the body. Your doctor will review your medical history and perform a physical examination to help determine the cause of priapism. After the physical exam is complete, the doctor will take a blood-gas measurement of the blood from the penis. During this test, a small needle is placed in the penis, some of the blood is drawn and then it is sent to a lab for analysis.

This provides a clue to the type of priapism, how long the condition has been present, and how much damage has occurred. Other Tests: Blood gas measurement. In this test, a tiny needle is inserted into your penis to remove a sample of blood. If the blood is dark — deprived of oxygen — the condition is most likely ischemic priapism. If it's bright red, the priapism is most likely nonischemic. A laboratory test measuring the amounts of certain gases in the blood can confirm the type of priapism. Blood tests. Your blood can be tested to measure the amount of red blood cells and platelets present. Results may provide evidence of diseases, such as sickle cell anemia, other blood disorders or certain cancers. Ultrasound. You may have a color duplex ultrasonography, which uses sound waves to create an image of internal organs. This test can be used to measure blood flow within your penis that would suggest ischemic or nonischemic priapism. The exam may also reveal an injury, tumor or abnormality that may be an underlying cause. Toxicology test. Your doctor may order a toxicology test to screen for illegal or prescription drugs that may be the cause of priapism.

This may be done with blood or urine samples. Treatment: The goal of all treatment is to make the erection go away and preserve future erectile function. If a person receives treatment within four to six hours, the erection can almost always be reduced with medication. If the erection has lasted less than four hours, decongestant medications, which may act to decrease blood flow to the penis, may be very helpful. Other treatment options include: Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling. Ice packs: Ice applied to the penis and perineum may reduce swelling. Surgical ligation: Used in some cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow. Intracavernous injection: Used for low-flow priapism. During this treatment, drugs known as alpha-agonists are injected into the penis that cause the veins to narrow, reducing blood flow to the penis and causing the swelling to subside.

Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal. NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. Priapism Types, Signs, Causes, & Treatment | Cleveland Clinic Share Facebook Twitter Linkedin Email Print Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and is unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction. Priapism can occur in all age groups, including newborns. However, it usually affects men between the ages of 5 and 10 and 20 and 50. There are two types of priapism: low-flow and high-flow. Low-flow priapism: This is the result of blood being trapped in the erection chambers.

It often occurs without a known cause in men who are otherwise healthy, but it also affects men with sickle-cell disease, leukemia (cancer of the blood) , or malaria. High-flow priapism: This is more rare and is usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (the area between the scrotum and anus), which prevents blood in the penis from circulating normally. What causes priapism? Sickle cell anemia: Some adult cases of priapism are the result of sickle-cell disease. Approximately 42% of all adults with sickle-cell will eventually develop priapism. Medications: A common cause of priapism is the use and/or misuse of medications, including drugs such as Desyrel (used to treat depression or as a sleeping aid) or Thorazine (used to treat certain mental illnesses). For people who have erectile dysfunction, injection therapy medications to treat the condition may also cause priapism.

Other causes of priapism include: Trauma to the spinal cord or to the genital area Black widow spider bites Carbon monoxide poisoning Illicit drug use, such as marijuana and cocaine In rare cases, priapism may be related to cancers that can affect the penis and prevent the outflow of blood. How is priapism diagnosed? If you have priapism, it is important to get medical care immediately. Tell your doctor: How long you have had the erection; How long your erection usually lasts; If you have used any medication or drugs, legal or illegal. Be honest with your doctor-- illegal drug use is especially of interest, since both marijuana and cocaine have been linked to priapism. Whether or not the priapism happened after trauma to that area of the body. Your doctor will review your medical history and perform a physical examination to help determine the cause of priapism. After the physical exam is complete, the doctor will take a blood gas measurement of the blood from the penis. During this test, a small needle is placed in the penis, some blood is drawn, and then it is sent to a lab for analysis.

This provides a clue to the type of priapism, how long the condition has been present, and how much damage has occurred. How is priapism treated? The goal of all treatment is to make the erection go away and preserve the ability to have erections in the future. If a person receives treatment within four to six hours, the erection can almost always be reduced with medication. If the erection has lasted less than four hours, decongestant medications, which may decrease blood flow to the penis, may be very helpful. Other treatment options include: Ice packs: Ice applied to the penis and perineum may reduce swelling. Surgical ligation: Used in some cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow. Intracavernous injection: Used for low-flow priapism. Drugs known as alpha-agonists are injected into the penis. They cause the arteries to narrow, reducing blood flow to the penis and causing the swelling to decrease.

Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal. Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling. If you think that you are experiencing priapism, you should not attempt to treat it yourself. Instead, get emergency help as soon as possible. What is the outlook for people with priapism? As long as treatment is prompt, the outlook for most people is very good. However, the longer medical attention is delayed, the greater the risk of permanent erectile dysfunction. References Merck Manual. Erection, Persistent (Priapism) Accessed 11/5/2015. © Copyright 1995-2016 The Cleveland Clinic Foundation. All rights reserved. This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

This document was last reviewed on: 11/5/2015...#10042 Related Institutes & Services Symptoms and causes - Priapism - Mayo Clinic Symptoms and causes Print Symptoms Priapism symptoms vary depending on the type of priapism. The two main types of priapism are ischemic and nonischemic priapism. Ischemic priapism Ischemic priapism, also called low-flow priapism, is the result of blood not being able to leave the penis. It's the more common type of priapism. Signs and symptoms include: Erection lasting more than four hours or unrelated to sexual interest or stimulation Rigid penile shaft, but the tip of penis (glans) is soft Progressive penile pain Recurrent or stuttering priapism, a form of ischemic priapism, is an uncommon condition. It's more common in males who have an inherited disorder characterized by abnormally shaped red blood cells (sickle cell anemia). Sickle cells can block the blood vessels in the penis. Recurrent priapism describes repetitive episodes of prolonged erections and often includes episodes of ischemic priapism.

In some cases, the condition starts off with unwanted and painful erections of short duration and might progress over time to more frequent and more prolonged erections. Nonischemic priapism Nonischemic priapism, also known as high-flow priapism, occurs when penile blood flow isn't regulated appropriately. Nonischemic priapism is usually painless. Signs and symptoms include: Erection lasting more than four hours or unrelated to sexual interest or stimulation Erect but not fully rigid penile shaft When to see a doctor If you have an erection lasting more than four hours, you need emergency care. The emergency room doctor will determine whether you have ischemic priapism or nonischemic priapism. This is necessary because the treatment for each is different, and treatment for ischemic priapism needs to be done as soon as possible. If you experience recurrent, persistent, painful erections that resolve on their own, see your doctor. You might need treatment to prevent further episodes. Causes An erection normally occurs in response to physical or psychological stimulation. This stimulation causes certain blood vessels and smooth muscles to relax and/or expand, increasing blood flow to spongy tissues in the penis.

Consequently, the blood-filled penis becomes erect. After stimulation ends, the blood flows out and the penis returns to its nonrigid (flaccid) state. Priapism occurs when some part of this system — the blood, blood vessels, smooth muscles or nerves — changes normal blood flow. Subsequently, the erection persists. While the underlying cause of priapism often can't be determined, several conditions are believed to play a role. Blood disorders Blood-related diseases might contribute to priapism — usually ischemic priapism, when blood isn't able to flow out of the penis. These disorders include: Sickle cell anemia Other hematologic dyscrasias, such as thalassemia, multiple myeloma and others The most common associated diagnosis in children is sickle cell anemia.

Prescription medications Priapism, usually ischemic priapism, is a possible side effect of a number of drugs, including: Medications injected directly into the penis to treat erectile dysfunction, such as alprostadil, papaverine, phentolamine and others Antidepressants, such as fluoxetine (Prozac), bupropion (Wellbutrin), and sertraline Alpha blockers including prazosin, terazosin, doxazosin and tamsulosin Medications used to treat anxiety or psychotic disorders, such as hydroxyzine, risperidone (Risperdal), olanzapine (Zyprexa), lithium, clozapine, chlorpromazine and thioridazine Blood thinners, such as warfarin (Coumadin) and heparin Hormones such as testosterone or gonadotropin-releasing hormone Medications used to treat attention-deficit/hyperactivity disorder ( ADHD ), such as atomoxetine (Strattera) Alcohol and drug use Alcohol, marijuana, cocaine and other illicit drug abuse can cause priapism, particularly ischemic priapism.

Injury A common cause of nonischemic priapism — a persistent erection caused by excessive blood flow into the penis — is trauma or injury to your penis, pelvis or perineum, the region between the base of the penis and the anus. Other factors Other causes of priapism include: A spider bite, scorpion sting or other toxic infections Metabolic disorders including gout or amyloidosis Neurogenic disorders, such as a spinal cord injury or syphilis Cancers involving the penis Complications Ischemic priapism can cause serious complications. The blood trapped in the penis is deprived of oxygen. When an erection lasts for too long, this oxygen-poor blood can begin to damage or destroy tissues in the penis. As a result, untreated priapism can cause erectile dysfunction. Shah AP. Priapism. Merck Manual Professional Version. Accessed May 10, 2016. Deveci S. Priapism. Accessed May 10, 2016. Heidelbaugh JJ. Urology. In: Clinical Men's Health. Accessed May 10, 2016. Wein AJ, et al., eds. Priapism.

In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. Accessed May 10, 2016. Ferri FF. Priapism. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. Accessed May 10, 2016. Salonia A, et al. European Association of Urology guidelines on priapism. European Urology. 2014;65:480. Stein DM, et al. Nationwide emergency department visits for priapism in the United States. The Journal of Sexual Medicine. 2013;10:2418. Related Priapism - Health Exchange You are here: Home > Health library > Article > Condition > Priapism Priapism Causes of priapism Priapism Find everything you need to know about Priapism, including causes, symptoms, diagnosis and treatment, with links to other useful resources. Priapism is a persistent and usually painful erection that lasts for several hours.

Priapism is not necessarily related to sexual stimulation or desire, and it does not subside after ejaculation (when semen is released from the penis). The most common cause of priapism is when blood cannot leave the penis. Priapism commonly arises as: a complication of┬á sickle cell anaemia (a genetic blood disorder where the red blood cells develop abnormally) a side-effect of medications such as sildenafil (sold under the brand name Viagra) that are used to treat┬ámen who┬áhave difficulty obtaining or maintaining an erection ( erectile dysfunction ) Priapism should be regarded as a medical emergency. If treatment is not started within 24 hours, the penis may be permanently damaged, which may affect the ability to get an erection in the future. How common is priapism? Priapism is rare in the general population but relatively common in certain high-risk groups, i.e. boys or men with sickle cell anaemia, and men who are taking medication to treat erectile dysfunction. It is estimated that 1 in 4 children with sickle cell anaemia and 9 out of 10 adults with sickle cell anaemia will experience at least one episode of priapism.

The risk of priapism as a side effect of treatment for erectile dysfunction is thought to be low at around 1 in a 1,000. Outlook The outlook for priapism that is treated promptly is good. There are a number of treatment options , such as medication or draining blood out of the penis, which can often manage symptoms successfully. However, the longer that treatment for priapism is delayed, the worse the outcome usually is, and the greater a personÔÇÖs chance of developing erectile dysfunction. ┬á Priapism Symptoms | Symptoma® Incidence: 8 / 100.000 Overview Priapism is characterized by penile erection that occurs without any kind of sexual stimulation. It is a painful condition requiring prompt treatment. Such condition occurs in young boys aged 5 to 10 years or in adults between 20 to 50 years of age. Priapism can be either ischemic or non-ischemic in nature. The condition can last for as long as 4 hours or even more. Priapism requires immediate medical intervention in order to avoid onset of irreversible conditions. Failure to treat the condition can call for development of erectile dysfunction [1].

Etiology In many cases, the exact cause of priapism remains a mystery. However individuals with sickle cell anemia are known to fall easy prey to this condition. Sickle cell anemia is a heredity blood disorder in which the abnormally shaped red blood cells inhibit blood flow to the penis giving rise to priapism [2]. In addition to sickle cell anemia , other type of blood disease such as leukemia is also known to play a role in causation of the disease. Research has also pointed towards the fact that certain drugs commonly used for treating sexual dysfunction , depression and psychotic disorder can also lead to development of priapism. There have been instances that have reported injury to be one of the major causes of non-ischemic priapism. Other causes of priapism include injury to the spinal cord, blood clots or poisonous venom. Epidemiology Priapism is an uncommon condition accounting for 1.5 cases per 100,000 individuals-years globally. A rise in the rate of incidence of priapism has been noted for men aged 40 years and above.

It has been estimated that in this older population the incidence increased to 2.9 cases per 100,000 individuals-years [3]. The condition can strike males at any age, but is more common in boys below 10 years and in men above 20 years. Pathophysiology Under normal conditions, penis erection occurs in response to sexual stimulation. Due to stimulation, the blood vessels relax and expand increasing the blood flow to the penis. Such sequence of events causes the penis to erect. When the stimulation ends, the blood flows out and the penis returns to its normal (flaccid) state [4]. When some kind of disruption occurs in these normal events, priapism develops. Ischemic (low flow) priapism is the most common type and occurs when the blood gets trapped in the penis and is unable to flow out. Such an event does not allow the penis to return to its normal state. Non-ischemic (high flow) priapism is pretty uncommon compared to the former type. It occurs when an artery gets ruptured that prevents the normal circulation of blood within the penis. Prognosis The prognosis of the condition can be favorable only if prompt treatment is initiated.

Failure to do so can result in development of permanent damage to the penis. When priapism continues for more than 24 hours then erectile dysfunction can set in permanently [5]. Presentation Symptoms vary depending on the type of priapism that has occurred. The following is a list of symptoms explaining both type of priapism. Ischemic (low flow) priapism Involuntary erection that lasts for at least 4 hours The penis is erect but not painful Workup In the preliminary phase, the individual will be asked about the length of the penile erection and frequency of the condition. Following this, a thorough physical examination will be carried out to understand the cause behind the development of priapism. In addition to this, the following methods will be carried out to diagnose the condition [7]: Blood gas measurement: In this blood is drawn from the penis to be analyzed for the type of gases present in the sample. Such a type of test determines the type of priapism present. Blood tests would be done to detect the presence of any underlying disease conditions such as sickle cell anemia or leukemia . Color duplex ultrasound examination will be carried out to detect presence of tumor or any other abnormality inside the penis.

This test would also provide insight into the type of priapism present. Toxicology test would help in revealing whether drug abuse is the cause of priapism. Treatment Treatment of priapism is geared towards relieving the erection and preserving the erectile function. If treatment is initiated within 4 to 6 hours of erection, then medications should be enough to correct the condition. In addition, the following methods are employed to treat priapism [8]: Ice packs: Application of ice packs to the penis and neighboring areas may help relieve the condition. Surgical ligation is employed when there is arterial rupture. In this process, the artery is tied in order to restore the blood supply. Shunt: In this a shunt is surgically inserted to divert the blood flow in order to restore the normal blood circulation in the penis [9] [10]. Needle aspiration: In this method, a needle is inserted into the penis to drain out the blood in order to correct the erection. Prevention Several steps can be followed to prevent recurrent attacks of priapism. If the cause of the underlying condition is known then appropriate treatment should be initiated to treat the condition. In case, drugs were the cause then attempts should be made to change the medications.

Men are also advised against use of recreational drugs and alcohol which have a known association with priapism episodes. The practice of self-injection of phenylephrine should be discouraged as it can trigger development of priapism. Patient Information Definition Priapism is prolonged erection of the penis without any physical or psychological stimulation. It is an extremely painful condition that should receive prompt treatment. Priapism can affect males of all age groups, but is more common in young boys and adult males. Cause Underlying disease conditions such as sickle cell anemia and leukemia are known to be major contributory factors. In addition, trauma or injury to the genital can also cause development of priapism. Individuals in the habit of using illegal drugs or alcohol are also susceptible. In many cases, it has been noticed that prescription drugs that have been advised for treatment of various disease conditions also predisposes males to develop priapism. Symptoms Symptoms of priapism include painful penile erection for 4 hours or more. The penis become rigid and may be tender to touch. Diagnosis Diagnosis is made through blood gas measurement in which blood that is trapped in the penis is tested for certain gases which confirms the presence of priapism.

In addition, blood tests and ultrasound for detecting the presence of various disease conditions are also done. Treatment Treatment of priapism is done through medications and surgical intervention. If the duration of erection is less than 4 hours then medications alone help rectify the condition. References Quan D, Ruha AM. Priapism associated with Latrodectus mactans envenomation. Am J Emerg Med. Jul 2009;27(6):759.e1-2. Pryor J, Akkus E, Alter G, et al. Priapism. J Sex Med 2004; 1:116. Eland IA, van der Lei J, Stricker BH, Sturkenboom MJ. Incidence of priapism in the general population.Urology. May 2001;57(5):970-2. Burnett AL, Bivalacqua TJ. Priapism: current principles and practice. Urol Clin North Am 2007; 34:631. Dubin J, Davis JE. Penile emergencies. Emerg Med Clin North Am.

Aug 2011;29(3):485-99. Muneer A, Minhas S, Arya M, Ralph DJ. Stuttering priapism--a review of the therapeutic options. Int J Clin Pract 2008; 62:1265. Bassett J, Rajfer J. Diagnostic and therapeutic options for the management of ischemic and nonischemic priapism. Rev Urol. Winter 2010;12(1):56-63. Montague DK, Jarow J, Broderick GA, et al. American Urological Association guideline on the management of priapism. J Urol 2003; 170:1318. Mains E, Aboumarzouk O, Ahmad S, El-Mokadem I, Nabi G. A minimally invasive temporary cavernoso-saphenous shunt in the management of priapism after failed conservative treatment. Minim Invasive Ther Allied Technol. Dec 5 2011 Brant WO, Garcia MM, Bella AJ, et al.

T-shaped shunt and intracavernous tunneling for prolonged ischemic priapism. J Urol 2009; 181:1699. A case of persistent priapism secondary to a transitional cell carcinoma of the left kidney - D Henderson - British journal of urology, 1950 - Wiley Online Library Hemolysis-associated priapism in sickle cell disease - VG Nolan, DF Wyszynski, LA Farrer - , 2005 - bloodjournal.hematologylibrary.org A case of penile metastasis of malignant melanoma with priapism - T Okinami, S Ishitoya, M Imamura, S Maeda - Hinyokika Kiyo. Acta , 2009 - ukpmc.ac.uk Clinical safety of oral sildenafil citrate (VIAGRA) in the treatment of erectile dysfunction.

- A Morales, C Gingell, M Collins, PA Wicker - International Journal of , 1998 - ukpmc.ac.uk Guidelines on erectile dysfunction - E Wespes, E Amar, D Hatzichristou, F Montorsi, J Pryor - European urology, 2002 - Elsevier What is Priapism? What is Priapism? If you’ve ever read the side effects of erectile dysfunction drugs or seen an advertisement for one, you’ve likely encountered the warning to seek medical attention for any erection lasting more than four hours. This condition is called priapism, and it’s a rare but serious side effect that can occur when taking erectile dysfunction medication . Priapism gets its name from the Greek fertility god Priapus, who is portrayed in art and sculpture as having a large, permanently erect penis. In actuality, a permanent erection would be anything but enjoyable. Priapism can cause extreme pain and, in some cases, permanent damage. Priapism is defined as a persistent or recurring erection that is not caused by sexual stimulation. It can happen in one of two ways: ischemic and nonischemic priapism.

An ischemic priapism, also called low-flow, occurs when blood in the penis does not drain properly back into the body. This is usually caused by a blocked or damaged vein. Nonischemic or high-flow priapism happens when too much blood flows into the penis. Of the two, ischemic priapisms are more common and also more serious. Despite its link to erectile dysfunction medicine, priapism can and does sometimes on its own. It is caused by a vascular problem, so any condition that may affect blood flow to the penis could be responsible for priapism. Children and adults can both experience priapism as a result of blood disorders like sickle cell anemia, leukemia, tumors, high blood pressure, trauma among other conditions. Symptoms and Indications of Priapism Priapism presents somewhat differently between patients, and the symptoms can vary depending on the root cause of the priapism.

The priapism signs to look out for include: • An unwanted erection that recurs frequently for several hours without sexual stimulation • An erection that will not go away after sexual activity has ended • A persistent erection that lasts for several hours • A penis with a rigid shaft but soft glans • A penis that is erect but not firm and rigid • Pain or tenderness in the penis • Discoloration, usually red or purple, of the penis Any or all of these symptoms may be present during priapism. Regardless of the presence of other symptoms, any persistent erection is considered a priapism and should be treated as a medical emergency. This means that you should still see a doctor even if you are not currently experiencing pain as the priapism itself may cause damage to the penile and vascular tissue if not treated. Why Is Priapism a Medical Emergency? In general, the persistent erection experienced with priapism is caused by poor circulation: Either too much blood pumps into the penis, or blood does not flow away from the penis and back to the rest of your body. In either case, blood can become trapped within your erectile tissue. Blood is pumped away from your heart through arteries and returns to the heart through your veins.

One of the purposes of blood is to transport oxygen throughout the body to nourish your cells and tissue. If blood becomes trapped in a vein, it will not return to circulate through your body, and it will not be properly oxygenated. This means that your tissue will be deprived of oxygen, essentially suffocating your cells. This in turn may result in tissue damage. This could cause future difficulties with achieving or sustaining an erection. In severe cases, it could also result in disfigurement or even gangrene of the penis. Most cases of priapism are treated before they get to this point, but early treatment is important to prevent future complications. Even a non-painful priapism can make you more likely to have a more severe or painful priapism in the future if there is no medical intervention taken to prevent this from occurring. What Causes Priapism? Normally, an erection is caused by physical or psychological stimulation of the penis. When stimulated, your body is prompted to modify the flow of blood, contracting some blood vessels while opening others. This increased blood supply flows into the penis, which is made of spongy tissue. As this tissue fills with blood, it expands and becomes rigid, creating an erection.

After sexual activity, or if stimulation stops, the blood vessels will return to their normal state. Blood will flow back out of the penis tissue, causing it to become flaccid. In priapism, this process is disrupted. A vascular issue may cause blood vessels to expand without stimulation, leading to an unwanted erection. These vessels may then stay expanded, keeping blood in the penis rather than allowing it to drain. Alternatively, the blood vessels may expand and contract at intervals without stimulation, resulting in intermittent erections. This condition is called stuttering priapism . There are several priapsim causes: • Blood disorders, like sickle cell anemia and leukemia. In these conditions, blood cells can be present in strange sizes, shapes or number. This can lead to blood vessels becoming blocked, inhibiting the flow of blood to and from the penis. • Erectile dysfunction drugs like Levitra , Cialis and Viagra . These drugs work by stimulating blood flow to the penis, but they can sometimes work too well, creating a persistent erection. • Other prescription drugs, including some antidepressants and blood thinners, which can also affect your circulation and create various circulatory problems including priapism. • Drug use, particularly cocaine.

Priapism 8 of the best free workouts on YouTube Priapism Priapism is a persistent erection, which is usually painful. Find out what the causes, complications and treatments are. MOST POPULAR Email What is priapism? Priapism is a persistent erection, which is usually painful. It's not necessarily associated with stimulation or sexual desire. Much debate has taken place as to the meaning of 'persistent erection'. But the current view is that the erection needs to be present for six hours. In practice, the usual recommendation is to seek medical help for a painful erection persisting for more than four hours. ADVERTISEMENT - CONTINUE READING BELOW What causes priapism? A normal erection results from relaxation of the muscles within the penis and an increase in arterial blood flow to the penis. The resulting swelling of the muscles compresses the penile veins, thus trapping blood within the penis. After ejaculation, the associated adrenaline surge constricts the arteries and relaxes the pressure on the veins, which leads to loss of erection (detumescence). MOST POPULAR Priapism may be spontaneous or caused by medical treatment (iatrogenic) and can occur in all age groups, including newborns.

However, it usually affects men between the ages of 5 to 10 years and 20 to 50 years. There are two categories of priapism: low-flow and high-flow. Low-flow This type of priapism is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but also affects men with sickle cell disease, leukaemia (cancer of the blood) or malaria . High-flow High-flow priapism is more rare than low-flow and usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally. Medically, the important issue is whether the condition is associated with high blood flow when there is little risk of tissue damage or low blood flow when the risk of damage is higher. Some 35 per cent of cases are idiopathic (unknown cause) and 21 per cent are associated with drug therapy or alcohol abuse . Trauma accounts for 21 per cent and blood disorders 8 per cent.

Although controversy exists over the way in which priapism occurs, a widely accepted view is that priapism results from injury or damage to the mechanism that produces detumescence of the penis. This damage can be caused by: blood disorders, particularly sickle cell disease, myeloma , thalassaemia and leukaemia . trauma, both accidental and surgical. damage to the nervous system, especially spinal cord injuries, but rarely multiple sclerosis or diabetes (this usually involves an element of overstimulation, resulting in high blood flow to the penis, as well as defective detumescence). alcohol. How is priapism treated? The presence of a painful erection for longer than four hours justifies a medical assessment by a GP or a visit to the Accident and Emergency Department if this is quicker. Many cases resolve spontaneously after repeated ejaculation, physical activity or a brisk walk. Oral terbutaline (eg Bricanyl) or salbutamol (eg Ventolin) may help if given early. Blood (50ml) can be removed by a doctor inserting a large bore (19G+) needle into the penis often in conjunction with heparin and saline to reduce clotting.

In resistant cases, a reversing agent, metaraminol (1 per cent solution), may be injected into the penis. In very rare cases, surgery is required to avoid permanent damage to the muscle of the penis. In cases in which priapism is related to an injection used to treat impotence , alternative therapy should be used in future. Luckily, with the development of oral drugs, cases of priapism due to impotence treatments are becoming increasingly rare. What are the complications of priapism? In very rare cases, unresolved priapism can lead to severe damage to the tissues of the penis. If this occurs, erections can be affected. In this case, an implant or prosthesis can be surgically placed within the penis. Other people also read: Priapism Treatments, Causes, Types, and Symptoms A Erections can’t happen without proper blood flow. Normally when a man gets aroused, the arteries in his pelvis and penis relax and expand, bringing more blood to spongy tissues in the penis . At the same time, the valves in the veins close, trapping blood in the area and causing an erection.

After the excitement ends, the vein valves open, the blood flows out, and the penis returns to its usual state. Blood flow that’s not normal can cause priapism , an erection that lasts for more than 4 hours, is usually painful, and may happen without sexual arousal. Recommended Related to Erectile Dysfunction It can happen to males of all ages, including newborns. There are two main types: Low-flow or ischemic priapism : This type happens when blood gets trapped in the erection chambers. Most of the time, there’s no clear cause, but it may affect men with sickle-cell disease, leukemia ( cancer of the blood), or malaria . If you don’t get treatment right away, it can lead to scarring and permanent erectile dysfunction (ED). High-flow or non-ischemic priapism: This type is more rare than low-flow and is usually less painful. It often happens when an injury to the penis or the area between the scrotum and anus , called the perineum, ruptures an artery, which prevents blood in the penis from moving normally. What Causes Priapism?

Sickle cell anemia: Scientists think about 42% of men with sickle cell disease will get priapism at some point. Medications : Many men get the condition when they use or misuse some types of medicine. Drugs that may cause priapism include the depression treatment trazodone HCL ( Desyrel ), or chlorpromazine (Thorazine), which treats some mental illnesses. The pills or shots that treat ED may also cause priapism. Other causes include: Carbon monoxide poisoning Using street drugs like marijuana and cocaine It’s rare, but priapism can happen because of cancers that affect the penis and prevent blood from flowing out of the area. Getting a Diagnosis If you think you might have priapism, you need to get medical care right away. Tell your doctor: How long you’ve had the erection How long your erections usually last Any drugs, legal or illegal, that you’ve used If the problem happened after an injury Your doctor will review your medical history and do a thorough physical exam to figure out what’s causing your problem. He’ll check your rectum and belly for any signs of cancer .

You may also need to see a urologist for more screening tests, including: Blood tests An imaging test called a color Doppler ultrasound , which shows how blood is flowing in your penis An X-ray called an arteriogram that detects a dye your doctor injects into an artery

Question: The medical condition priapism is a persistent and usually painful what?
Answer: Erection