Priapism -- When an Erection Will Not
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May 11, 2014
By A. Lee, Associate Editor and Featured Columnist

Priapism is a condition in which the penis remains hard for 4 hours or
longer. Priapism takes its name from Priapus, a mythical Greek god of
fertility who was renowned for his massive penis. However envious you
may be of Priapus, you would never want to be afflicted with priapism.  
Priapism is unrelated to sexual stimulation and can be a serious medical
condition which,  left untreated, can lead to death of the cells at the
end of the penis or worse.

Two Types of Priapism

There are two main types of priapism.  Non-ischemic Priapism usually
occurs after a trauma or accident. This type of priapism is not painful
and does not require emergency medical treatment to resolve.  

The other type of priapism is “ischemic  priapism”. Ischemic priapism is
painful and is in fact a medical emergency.  If you have priapism and it
comes and goes but when it appears, it is painful, then this si called
“stuttering ischemic priapism”  or “recurrent priapism” and you need
to seek medical attention --- now.

What Causes Priapism?

Many cases of priapism are caused by sickle cell anemia. Up to 42% of
all men with sickle cell anemia experience priapism, according to a 2014
study led by Dr. Alan Shindel of  the Department of Urology at the  
University of California in San Francisco.

Other causes of priapism are overuse of Viagra and other erectile
enhancement drugs.

Still other cases are caused by blockages in the vascular system of the
penis which allows blood to flow in but not out.

Should You Massage the Penis to Reduce Priapism?

Currently, doctors do not advise massage as a remedy for priapism. It
could in fact make the condition worse. The only treatment you should
apply is to call emergency services and get to the hospital as soon as
possible once your erection lasts longer than 3 to 4 hours.

Once you are under a doctor's care, he or she will decide the next
steps. Usually, if you  have ischemic priapism, the first steps involve
"therapeutic aspiration", using ultrasound and drawing out the fluid
with a needle.  

If this doesn't work, then doctors may operate to insert a shunt to aid
the removal of excess blood and fluid. Your doctor may take different
steps or other steps, but these are the usual steps, according to a  
2013 study led by Dr. Phil Hyun Song of the Department of Urology,
Yeungnam University College of Medicine in Daegu, Korea.

Dangers of Priapism

Priapism can lead to long-term or irreversible damage to your penis.
Among the dangers of priapism listed in the University of California
study are “trabecular interstitial edema, cellular death, corporeal
fibrosis, erectile dysfunction and, in extreme cases, penile necrosis”.

Penile necrosis is dry gangrene that usually occurs at the final stages of
renal (kidney) disease or Type 2 diabetes.  Your penis literally rots off.
Not a good ending.

So, penile necrosis and priapism are yet another reason to follow the
mantra we preach to get your blood sugar levels under control and
keep them under control throughout your life.

Remedies to Prevent Priapism

Do Not Overuse Viagra, Cialis and other ED drugs. Priapism related
to overuse and abuse of Viagra (sildanefil) and other ED drugs is
actually quite rare. The FDA only received 93 such cases in all of 2007,
for example. However, priapism risk is slightly elevated by use of these
drugs, so do not overuse them. Follow the manufacturer's directions to
the letter and , whatever you do, never but Viagra-like pills from non-
regulated sources on the internet.

Get Checked for Sickle Cell Anemia and Leukemia.  This is especially
important if you are African American.

3. Beware of Trazadone Side Effects. Trazadone is a drug used to treat
depression. Trazadone puts you at increased risk for priapism.

Know Your Blood Sugar Levels. Maintain healthy blood sugar levels
by eating a
low glycemic diet and exercising regularly.

Do Not Continue to Have Sex. Having sex might strike you as the
natural way to deal with an erection that won't subside. Wrong. If your
case of priapism is caused by blockages that allow blood into the groin
area but not out of it, then getting aroused would just add more blood
flow to the area. So, it could make the problem worse, not better.

Get Regular Checkups.  None of these “remedies” may prevent
priapism in all cases. That’s why it is important, guys, to get a physical
regularly. Especially if you are over 40, make sure it’s an annual gift
you give yourself.

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Abuse of Viagra and similar drugs can
lead to priapism.