Priapism refers to a painful, prolonged erection that endures beyond four hours and is not related to sexual arousal. This condition can cause ischemic damage to penile tissues and lead to impotence. It can arise from blood disorders, injuries to the perineum and penis, tumors affecting the nervous system, or substance use such as drugs or alcohol, according to medical experts in urology.
A key characteristic of priapism is that the erection does not subside after orgasm. Possible causes include blood diseases such as leukemia, erythrocytosis, and sickle cell anemia, trauma to the perineum or penis, tumors of the central or peripheral nervous system, and the abuse of psychoactive substances or alcohol, physicians explain.
There are three main types of priapism based on the mechanism of development: ischemic, non-ischemic, and recurrent.
The ischemic type is the most frequent. It results from the stagnation of venous blood within the corpora cavernosa, a condition that can be dangerous because tissue scarring may occur due to impaired blood flow. Even after the episode resolves, erectile dysfunction can develop, and irreversible tissue changes can begin within approximately 24 hours from onset. Prompt medical evaluation is essential to prevent lasting damage.
The non-ischemic form arises from damage to penile vessels, leading to reduced blood flow and mild tissue deprivation. In this scenario, irreversible changes may also occur, though the progression and long-term impact can differ from ischemic priapism.
Recurrent priapism is the least understood and most perplexing variation. It features episodic erections interspersed with normal periods, and timely treatment is important. In non-ischemic priapism, procedures to occlude the abnormal vascular communication are commonly considered to halt the abnormal blood flow.
When ischemic priapism is suspected, emergency medical care is critical to prevent complications. Immediate actions typically include removing blood from the penis to restore oxygenation and administering medications that regulate blood flow. In some cases, anticoagulants may be used as part of the treatment plan, with medical supervision guiding each step.
Awareness of priapism and its urgency can help reduce the risk of long-term penile damage. Early consultation with a healthcare professional is advised if an erection persists beyond four hours, or if there are any signs of pain, swelling, or abnormal color changes in the penis.
The discussion around priapism underscores the importance of timely diagnosis and comprehensive care to protect sexual health and overall well-being.