What is Priapism

Priapism is an unwanted erection of the penis that usually develops without sexual stimulation or desire. Priapism affects males of all ages. There are three types of priapism:

• Recurrent acute priapism. With this type, erections are painful and last less than 3 hours. The erections come and go.
• Acute prolonged priapism. With this type, erections are painful and last hours to days. This type can lead to erectile dysfunction.
• Persistent priapism. With this type, erections are usually painless and can last weeks to years. The penis gets erect but not rigid. This type can lead to erectile dysfunction.

What are the causes?

This condition develops either when blood has difficulty leaving the penis (low-flow priapism) or if too much blood flows into the penis (high-flow priapism). Blood flow issues may be caused by:

• Erectile dysfunction medicine. This is the most common cause.
• Medicine that is used to treat depression and anxiety.
• Blood problems that are common in people who have sickle cell disease or leukemia.
• Use of illegal drugs, such as cocaine and marijuana.
• Excessive alcohol use.
• Neurological problems, such as multiple sclerosis.
• Diabetes mellitus.
• An injury to the penis.
• An infection.

In some cases, the cause may not be known.

What are the signs or symptoms?

Symptoms of this condition include:

• A prolonged erection.
• A painful erection.

How is this diagnosed?

This condition is diagnosed with a physical exam. Blood tests may be done to help identify the cause of the condition.

How is this treated?

Treatment for this condition depends on the cause and the type of priapism. Recurrent acute priapism is often managed at home. Acute prolonged priapism is usually treated at a hospital, where treatment may involve:

• Getting fluid and medicines for pain through an IV tube.
• A blood transfusion.
• A procedure to drain blood from the penis.
• Surgery to make a passageway for blood to flow in the penis (surgical shunting).

No standard treatment exists for persistent priapism.

Follow these instructions at home:

Managing Recurrent Priapism

• Try taking a warm bath or exercising.
• Keep track of how long your erection lasts. If it does not go away in 3 hours, seek medical care.

General instructions

• Avoid sexual stimulation and intercourse until your health care provider says that they are okay for you.
• Avoid drugs or alcohol if they caused the priapism. Avoiding them can help to prevent the condition from coming back.
• Drink enough fluid to keep your urine clear or pale yellow.
• Empty your bladder as much as possible.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take any medicines during an episode unless you get approval from your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain gets worse.
• Your pain does not improve with treatment.
• You have recurrent priapism and your erection does not go away in 3 hours.

Get help right away if:

• You have a fever or chills.
• You have pain, swelling, or redness in your genitals or your groin area.