Priapism

Priapism.  Photo from www.ship.edu

Priapism — an involuntary erection unrelated to sexual arousal that lasts more than 4-6 hours. The erection of such duration is inevitably accompanied by tenderness, discoloration of skin of the penis. It requires immediate medical attention!

Priapism can develop at any age, but more often — in children 5-10 Years of age and in men 20-50 Years. This is a fairly rare condition, patients with this problem are only 0.2% of all those who applied to the doctor for sexual disorders.

The causes of priapism

Urgent, please contact your doctor immediately:

  • If an erection lasts more than four hours
  • if the erection lasts less than 4 hours, but is accompanied by pain

The immediate cause of priapism is a violation of the blood flow in the cavernous (cavernous) bodies of the penis. In some cases there is a significant increase in arterial blood flow, resulting in an overflow of the corpora cavernosa (it happens more often with the injuries of the penis) — nonischemic priapism. In other sluchyaah occurs deterioration of venous outflow from the stagnation of blood and change its properties — ischemic priapism.

Diseases in which priapism can occur:

  • neurological disorders (brain tumor, spinal cord injury, the consequences craniocerebral injury, multiple sclerosis);
  • diseases of the blood (leukemia, sickle cell anemia);
  • diseases of male genital organs (inflammation, tumors and trauma of the penis);
  • intoxication (cocaine or receiving excessive amounts of alcohol, chronic renal failure);
  • genital injuries, pelvic or perineal.

Other factors that lead to priapism:

  • Spinal Cord Injury
  • Diseases of the Nervous System — Multiple Sclerosis
  • Metabolic diseases — diabetes
  • Blood clots
  • Poisoning toxins, such as scorpion or black widow.

Medicines that may cause priapism:

  • drugs used for the treatment of erectile dysfunction (siledenafil (Viagra), vardenafil (Levitra)).
  • drugs administered directly into the penis to treat impotence;
  • antidepressants — Prozac buporpion (Wellbutrin);
  • psychotropic drugs — risperidone (Risperdal), olanzapine (Zyprexa);
  • antianxiety drugs — diazepam (Valium);
  • indirect anticoagulants — warfarin, heparin.

What if this happens?

True priapism begins suddenly, usually during sleep. The penis becomes very stressful. At the same time urination is usually not affected, since the blood overflow only the corpora cavernosa of the penis and urethra, prostate and head of the penis in erection is not involved. Erection accompanied by pain at the root of the penis and perineum, emerging a few hours after the attack, and sometimes swelling of the penis, especially the foreskin.

Sexual arousal is not typical for priapism. Sexual intercourse does not bring relief, because it ends with ejaculation and does not lead to a weakening of erection, but only intensifies the pain.

Intermittent night priapism manifested in the form of short-term painful penile erections during sleep. At first erection with revivals are quite rare (eg once a week), but gradually become more frequent, occur several times during the night and become more painful. Unlike true priapism erection weakens after waking up, emptying of the bladder, rectum, active movements, walking, receiving sedatives or hypnotics.

Diagnostics

With painful erections lasting several hours to seek medical advice immediately. Despite the complaints expressed, men often seek treatment too late. The main reason is modesty, and often not knowing which doctor to turn to. Universal Board — call the "first aid".

The diagnosis of priapism sets andrology, a urologist or surgeon at the examination. You will be assigned to a comprehensive survey, as for priapism may be hiding a very serious disease.

Type of priapism can be determined using the study of blood gases -the penis inserted a fine needle for taking a small amount of blood. If the blood is dark, it most likely ischemic priapism, if light red — non-ischemic. Laboratory studies of blood gases are more accurate.

Treatment

The earlier the treatment, the more effective it is. In the initial phase of treatment is carried puncture of the corpora cavernosa of the penis using a special needle under local anesthesia, suction excess blood and injections of vascular drugs. Because these drugs can get into other vessels and cause a drop in blood pressure and loss of consciousness, treatment should only be carried out in a medical hospital with constant monitoring of blood pressure.

If drug treatment of priapism is unsuccessful, a surgical emergency. It is to create a drainage vessel between the veins of the penis and other veins to accelerate the outflow of blood. Even in the case of an effective treatment, you have to be prepared for what may occur after treatment of temporary impotence. But do not worry — after a while sexual function returns to normal.

Nonischemic priapism often resolves on its own without treatment. Because the risk of tissue damage in this type of priapism is not there, the doctor may choose watchful waiting. Forcing cold to the perineum, the base of the penis can help return the penis to its normal state.

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