Priapism is an uncommon condition that causes a prolonged and often painful erection, which occurs without sexual stimulation. In a third of the cases, the cause is unknown. The remaining cases are caused by an associated condition, including sickle cell disease, pelvic tumors, pelvic infections, leukemia, genital trauma or spinal cord trauma, and medications or recreational drugs.
Priapism is classified into two types — ischemic (no-flow) or non-ischemic (high-flow).
Symptoms of priapism include a prolonged and often painful erection without sexual stimulation.
Diagnosis involves a medical history and examination to determine any underlying medical causes and the duration of the condition. During the medical examination, your doctor will assess the severity of pain, the rigidity of the penis and lack of involvement of certain parts of the penis. This also will include checking the rectum and the abdomen for evidence of unusual growths or abnormalities that may indicate the presence of cancer. In addition, a sample of your blood will be analyzed to exclude sickle cell disease, thalasaemia major and leukemia.
Diagnosis of non-ischemic priapism also involves a medical history and examination to determine any underlying medical causes and duration of the condition. In addition, your doctor will conduct a Doppler examination, which measures the blood flow of your penis.
When in doubt, a small needle may be placed in the penis to draw some blood, which is then sent to a lab for analysis. This will help determine which type of priapism the patient is experiencing.
Treatment for all forms of priapism aims to eliminate the erection and pain and preserve normal erectile function. Doctors recommend that anyone experiencing an erection lasting four hours should seek medical evaluation and treatment.
Ischemic priapism is considered a medical emergency and requires immediate treatment. If left untreated, the condition can significantly damage erectile function.
In the early stages of ischemic priapism, a cold shower or ice pack may relieve symptoms. Exercise in the form of climbing stairs also may help. Medications, such as analgesics and opiates to control pain, may be recommended as well.
Other treatments for the condition include:
Reviewed by health care specialists at UCSF Medical Center.