Priapism is a rare condition involving an erection that lasts for an unusually long time. It can be painful. This type of erection is not related to sexual stimulus. Immediate treatment is important to prevent tissue damage and erectile dysfunction (ED).
There are two types of priapism:
- Ischemic priapism: when blood cannot leave the penis. This erection can last for more than four (4) hours. The penis shaft may be very hard, while the tip is soft. It is known to cause pain and discomfort. This type may stop and start (stuttering priapism).
- Nonischemic priapism: when too much blood flows into the penis. This is a less painful erection, but it can also last for more than four (4) hours. The penis shaft is erect but not rigid. Priapism can happen in young boys (age 5-10), young adults (around age 20) and mature men (over age 50).
Normally, a penis becomes erect when an emotional or physical stimulus increases blood flow to the area. More blood in the penis causes blood vessels and nerves to respond as an erection. Priapism happens when blood flow to the penis doesn’t work correctly. Some things that could cause this are:
• Blood disorders, like sickle cell anemia and leukemia
• Prescription drugs, like some ED drugs, e.g. Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), mental health drugs, e.g. Fluoxetine (Prozac), Bupropion (Wellbutrin), Risperidone (Risperdal) and Olanzapine (Zyprexa) and blood thinners, e.g. Warfarin (Coumadin) and heparin
• Alcohol and drug use
• Injury to your genitals, pelvis or the area between the penis and the anus; or to the spinal cord
To learn why you are having priapism, and which type, talk to your health care provider. He or she will ask questions and examine your genitals, abdomen, groin and perineum. Your doctor will want to learn your symptoms, and if you’ve had an injury. Blood tests, blood gas measurements and a blood flow ultrasound may be used to help diagnose the cause.
When an erection lasts for too long, blood becomes trapped in the penis. The blood trapped in the penis is unable to go to other parts of the body. A function of blood is to carry oxygen to your body. When the blood is trapped, it means oxygen is trapped as well. This means other parts of your penis and body are not receiving oxygen from the trapped blood. The lack of oxygen can damage or destroy tissue in the penis. This can disfigure the penis. It may also cause problems like erectile dysfunction (when the penis cannot become erect).
If you have an erection that lasts for four (4) or more hours, go to the emergency room for treatment. If a long-term erection eventually goes away, still make time to see your doctor. Treatment can prevent this from happening again and from causing damage.
Learn more about this condition on a recent episode from our Urology Care Podcast: