Understanding Priapism
by Karen Barrow
It's been alluded to on television emergency-room
dramas, laughed at in the movies and cited as a warning for those
taking popular medications. But it is unlikely that you have ever
heard the real medical name of this condition and the serious
impact it can have on a man's life.
Priapism is a condition that causes a prolonged
erection that can result in pain and discomfort. While many make
jokes about this condition, it can be very dangerous and medical
attention needs to be sought immediately.
The good news is that priapism is incredibly
rare, but it does occur more often in certain high risk populations,
such as in people with sickle cell anemia and those who take particular
medications.
What causes priapism?
This disease can occur at any age, even in infants,
but is generally seen in two distinct populations: between the
age of 5 to 10 and between 20 to 50. While priapism itself is
always identified as an erection that lasts for at least four
hours, there are various causes of priapism, and none of them
stem from sexual activity.
For children, the most common causes of priapism
are leukemia and sickle cell anemia. In the case of leukemia,
white blood cells block the outflow of blood from the penis, causing
it to form an erection. Sickle cell anemia, on the other hand,
causes priapism because the abnormally-shaped blood cells can
prevent blood flow out of an erect penis. In fact, "42 percent
of all sickle-cell adults and 64 percent of all sickle-cell children
will eventually develop priapism," writes Dr. Christopher
Steidle, author of The Impotence Sourcebook.
Other, rarer causes of priapism in children include
trauma to the groin area, side effects from certain medications
and spinal cord injuries.
In adults, priapism may be caused by unknown
reasons. But, when a cause can be diagnosed, it usually stems
from sickle-cell disease and drug injections to treat erectile
dysfunction. Other legal drugs, such as some that treat high blood
pressure or mental disorders can also cause the condition, as
well as illicit substances, like marijuana and cocaine. Occasionally,
priapism is tied to rare abdomen or rectal cancers.
How is priapism treated?
If you experience an erection for four hours
or more, be sure to seek medical treatment immediately. Your doctor
has several treatment options to pick from depending on the cause
of your condition.
It is important to be honest with your doctor
about any medications or drugs you took earlier in the day, as
well as when the erection began.
Most likely, your doctor will first get a blood-gas
measurement by taking a small sample of blood from your penis.
This will help the doctor figure out the cause of the condition.
The first line of treatment is often a drug that
relaxes the muscles and walls of the arteries, such as terbutaline
or albuterol. This drug may help the blood that is in the penis
to escape and provide some relief. However, once the condition
lasts for several hours, this treatment becomes much less effective.
Therefore, a doctor often needs to remove the excess blood from
the penis manually with a small needle. And fortunately, "if
the treatment is done early in the course of the disease, this
is all that is necessary," writes Steidle.
If the priapism is recurring, however, a minor
surgical procedure may need to be performed to drain the blood
from the penis and create a shunt to prevent excess blood flow
to the area.
Are there any side effects?
Steidle estimates that about 50 percent of men
who experience priapism will develop some degree of erectile problems.
Additional problems include infections, bleeding and skin irritation.
In extremely rare cases, especially if a shunt
is placed in the penis, a blood clot may form in the area, blocking
blood flow and forcing doctors to surgically remove the affected
area.
Medically Reviewed On: September 19, 2006
About the Author
Karen Barrow is a copyeditor/writer for Healthology. Previously,
Karen has written for the New York Sun, Science World, Super Science
and The Jewish Week. She obtained a master's degree in biomedical
journalism from New York University and a bachelor's degree in
biology from Cornell University.
Erectile Dysfunction
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