Priapism

Priapism is a prolonged and often painful erection that lasts for more than four hours without sexual stimulation. It is a urological emergency that requires prompt medical attention to avoid permanent tissue damage. This condition occurs when blood becomes trapped in the penis, disrupting normal circulation.

There are two main types of priapism: Ischemic (low-flow) and non-ischemic (high-flow). Ischemic priapism is more common and caused by restricted blood outflow, leading to oxygen-deprived tissues and severe pain. Non-ischemic priapism usually results from an injury causing uncontrolled blood inflow, and while less painful, it still needs evaluation.

Common risk factors include sickle cell disease, blood disorders, spinal cord injury, certain medications for erectile dysfunction, and drug or alcohol use. Symptoms may involve persistent erection, pain, penile tenderness, or abnormal hardness.

If untreated, priapism can lead to erectile dysfunction or permanent tissue damage. Diagnosis may involve physical examination, blood gas analysis, and imaging tests. Treatment depends on the type and may include aspiration of trapped blood, medications, or surgery in severe cases. Early intervention greatly improves outcomes and preserves erectile function. Prompt consultation with a urologist is essential.