Priapism is a medical condition characterized by a persistent and often painful erection that lasts for more than 4 hours and is not related to sexual arousal or stimulation. It occurs when blood becomes trapped in the penis, preventing it from returning to its flaccid state. Priapism is a urological emergency and requires immediate medical attention to prevent permanent damage to the penile tissue.

Types of Priapism:

1. Ischemic (Low-Flow) Priapism:

   • The most common and serious type.

   • Caused by blood not draining properly from the penis, leading to a lack of oxygen in the penile tissue.

   • Painful and requires urgent treatment to prevent tissue damage and erectile dysfunction.

2. Non-Ischemic (High-Flow) Priapism:

   • Less common and usually less painful.

   • Caused by excessive blood flow into the penis, often due to an injury or trauma.

   • Not typically a medical emergency but still requires evaluation.

Causes:

• Ischemic Priapism:

  • Sickle cell anemia (most common cause in children and adolescents).

  • Blood disorders (e.g., leukemia, thalassemia).

  • Medications (e.g., erectile dysfunction drugs like sildenafil, antidepressants, blood thinners).

  • Recreational drugs (e.g., cocaine, marijuana).

  • Alcohol abuse.

  • Spinal cord injuries or trauma.

• Non-Ischemic Priapism:

  • Trauma to the penis or perineum (e.g., a blow to the groin).

  • Arterial damage causing abnormal blood flow.

Symptoms:

• Erection lasting more than 4 hours.

• Pain or tenderness in the penis (common in ischemic priapism).

• Rigid penile shaft with a soft tip (in ischemic priapism).

• Partial or less painful erection (in non-ischemic priapism).

Complications:

If left untreated, priapism can lead to:

• Permanent erectile dysfunction.

• Tissue damage or necrosis (death of penile tissue).

• Scarring and deformation of the penis.

Treatment:

• Ischemic Priapism:

  • Immediate medical intervention is required.

  • Treatments include:

    • Aspiration: Draining blood from the penis using a needle.

    • Injection of medications (e.g., phenylephrine) to constrict blood vessels and reduce blood flow.

    • Surgery (in severe cases) to redirect blood flow.

• Non-Ischemic Priapism:

  • Often resolves on its own but may require:

    • Observation.

    • Embolization (a procedure to block abnormal blood flow).

When to Seek Help:

Priapism is a medical emergency. If you or someone experiences an erection lasting more than 4 hours without sexual stimulation, seek immediate medical attention. Early treatment is crucial to prevent long-term complications.