Priapism
What is priapism?
Priapism is a persistent, painful erection that is not caused by sexual desire or sexual stimulation. If your erection lasts for too long (more than 3 hours), you should see a doctor immediately to avoid permanent damage to the penis. It’s believed that priapism is the result of problems with the nerves and blood vessels in the penis, which trap too much blood in the penis’ erectile tissue, the corpora cavernosa.
Priapism can be serious, and can result in a loss of sexual functioning, unless treatment is sought very quickly.
What causes priapism?
Sometimes, the cause of priapism isn’t certain, but in many cases, it can be seen as a possible side effect of prescription medications, or illicit drugs such as marijuana and cocaine.
Medicines that can result in priapism include:
- medicines used to thin the blood, called anticoagulants;
- chlorpromazine, used for psychotic illness such as schizophrenia;
- corticosteroids, used to treat a variety of conditions such as allergic reactions to drugs, asthma, itchy skin rashes, chronic inflammatory diseases and autoimmune diseases;
- some types of high blood pressure medicines, such as prazosin, an alpha-blocker medication; and
- medicines that are used to treat impotence, such as alprostadil.
Physical causes of priapism include:
- a tumour in the spine or in the pelvis;
- problems with the blood, such as leukaemia, blood clots, or sickle cell disease; and
- an infection in the genitals, such as prostatitis, urethritis or cystitis.
What treatments are available?
In general, the type of treatment or medicine recommended for priapism depends on its cause. If a medicine is the suspected cause of priapism, your doctor may suggest that you stop taking that medicine and try an alternative. If you have a blood clot in the penis, you will need to have surgery to remove it so that blood can flow normally through the penis again.
For immediate relief, and to prevent permanent damage to the penis, a doctor may use a needle to drain the extra blood trapped in the penis, and may also inject a vasoconstrictor agent (a medicine to narrow blood vessels) to restore normal blood flow. If this does not work, urgent surgery is needed.
In some cases, ice packs to the penis and perineum (the area between the base of the penis and the anus), or vigorous exercise such as climbing stairs, may help end the erection. However, it is important to see a doctor for treatment to avoid permanent damage to the penis.
Last Reviewed: 16 December 2009
- 1. Andrology Australia [website]. Penis problems (published 2007, August). Available at: http://www.andrologyaustralia.org/docs/Factsheet_PenisProblems.pdf (accessed 2009, December 18)
2. UAU guideline on the management of priapism. Linthicum, Md.: American Urological Association Education and Research, Inc. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=priapism. Accessed Oct. 20, 2008.
3. MayoClinic.com [website]. Priapism (updated 2008, Dec 5). Available at: http://www.mayoclinic.com/health/priapism/DS00873 (Accessed 2009, Dec 21)
