A 40 year old presented with an erection lasting about 10 hours which was causing him a lot of discomfort . Initially he was very happy about the erection but as time wore on he started getting worried . I don’t need it anymore doc ! Can you fix this ?
Priapism is a persisting abnormal erection of the penis which ocThe most common causes of priapism could be drugs like antipsychotics, anti hypertensives , injectable prostaglandins, recreational drugs like cocaine, marijuana, some blood disorders and infections . Sometimes a penetrating injury to the penis can cause the same .Priapism may be painless when it is high flow and the presentation maybe after many weeks . A low flow or ischemic priapism is painful.
It is important to treat ischemic priapism as an emergency as priapism lasting more than 12 hrs may cause permanent damage in terms of impotence . Treatment usually involves injection of certain drugs into the penis and also the use of suction irrigation with saline in the blood filled chambers of the penis. Refractory cases may need surgery .curs without sexual stimulation and persists in spite of sexual intercourse or masturbation. The American Urological association defines the time limit as exceeding 4 hrs . Priapism can be either caused by a low flow or a high flow mechanism .
Though priapism rarely ever occurs with Pde5 inhibitors ( Viagra like drugs) , a pronged erection more than 48 hrs should warrant immediate attention .