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Most men dream of an impressive erection with a long-lasting effect. For erectile dysfunction, there are many aids that can restore erectile function. However, there is also a medical condition or phenomenon that involves a permanent erection.
What sounds practical at first glance is very troublesome for the men affected and requires medical attention. If you suffer from a prolonged erection, don’t be afraid to ask a doctor or even an emergency doctor for help. We will explain to you how it comes about and what the consequences are.
Simply explained: What is priapism?
If you are familiar with Greek mythology, you may have heard of Priapus. Aphrodite’s son is one of the gods of fertility and was often depicted with an oversized and erect penis. The condition, which has been known since 1824, owes its name to him. The symptoms include a prolonged erection lasting more than four hours that is not linked to sexual stimulation.
Put simply, it means: if you have an erect penis for several hours but are not in an erotic mood, you may have priapism.
What causes priapism?
There are many causes of this unpleasant condition. Medication is a common trigger. Typical drugs include:
- Prostaglandin E1 (injected into the penis)
- Papavarin
- Benzodiazepines (for sedation)
- Blood pressure medication
- Anticoagulants
- Antidepressants
The use of drugs such as marijuana or cocaine and the use of hormones such as testosterone in sports can also lead to priapism.
If medication is not the cause, there are other triggers that may be harmless or disease-related. The disease patterns include:
- Prostate cancer/urethral cancer
- Diabetes
- Nephrotic syndrome
- Lupus
- Sickle cell anemia
- Malaria
Your doctor will first take your medical history and ask certain questions (are you taking medication, have you had treatment for erectile dysfunction) and then probably take a blood sample and examine it. Based on the results, the cause will be determined and targeted treatment initiated.
What are the symptoms of priapism?
An erection does not automatically constitute priapism. To be considered priapism, the stiffening of the penis must last for several hours (sometimes four hours is mentioned, sometimes two hours). It is characterized by the absence of sexual stimulation. In the case of classic priapism, you feel pain and your penis can become distorted due to the long-term erection. If the phenomenon persists, the glans and foreskin turn blue, followed by the rest of the penis.
Note: A special case is high-flow priapism, which has similar symptoms but is painless.
High-flow and low-flow priapism are different. The former occurs when blood flows into the erectile tissue, causing an erection. Low-flow priapism occurs when blood can no longer drain from the upper corpora cavernosa. In both forms, the penis will bend upwards after a few hours, since the corpora cavernosa are located there.
How to treat priapism
If your erection lasts more than two hours and is very painful, it is a medical emergency. You don’t have to call an ambulance immediately, but you should see a doctor or, outside office hours, a medical emergency service. To find out where this is possible in your city, call 116117. The doctor can often make the diagnosis based on your symptoms and use an ultrasound to see if there is a local problem. The treatment is then initially pain-relieving. There are medications that relax the penis and reduce the erection.
The doctor can often make the diagnosis based on your description of the symptoms and use an ultrasound to see if there is a local problem. The treatment then begins with pain relief. There are medications that reduce swelling in the penis. If this is not successful after 30 minutes, the blood can be manually suctioned out of your erectile tissue using a syringe. If another erection occurs, the erectile tissue is treated with injections to prevent it.
In rare cases, surgery is necessary. This is the case when the blood from your penis cannot drain again. In this case, the penile arteries are dilated or a so-called shunt is inserted. You can then get an erection again without it lasting permanently afterwards.
Differences in the treatment of high-flow and low-flow priapism
The exact treatment also depends on the type of priapism. High-flow priapism is considered less dangerous. Under medical supervision, conservative measures may be sufficient.
These include:
Compression of the penis with a blood pressure cuff
Cooling of the erectile tissue to cause the vessels to contract
Bed rest and pain-relieving medication
Low-flow priapism is significantly more dangerous, and a puncture is performed more quickly. If vasoconstrictor medications are used, you will be monitored medically in most cases. This way, your doctor can ensure that the rest of your vessels do not suffer.
Is the treatment of priapism painful?
The thought of someone sucking blood out of your penis with a needle is probably quite unpleasant. Doctor games are popular in the BDSM area, but when it is really medical, the erotic aspect quickly loses its effect.
The puncture is performed under general or local anesthesia. Your doctor will discuss this with you individually. You will not feel anything except for your penis going limp as quickly as possible and the tissue being relieved. There are two typical procedures for draining the blood.
In a procedure known as a Winter shunt, the puncture is made through the glans. The doctor creates a connection between the erectile tissue of your urethra and your penis. The blood is diverted and drains away through the erectile tissue of the urethra. The small incision is then closed again.
When a bypass is set, the incision is made at the base of the penis. The erectile tissue is then connected to the inguinal vein using a shunt. The blood then drains away there and the incision is closed. Since both procedures are minimally invasive, you don’t have to worry about extensive scarring.
In both cases, you may have to wear a urinary catheter for several days afterwards. However, the doctor will discuss all of this with you. If priapism is treated as quickly as possible, the chances of success are best. Your doctor will explain possible consequences (erectile dysfunction, scarring) to you before the procedure.
Conclusion: Priapism is not a harmless erection enhancer
Even if not every form of priapism is painful, you should always seek medical help immediately. The success of the therapy depends largely on the time of treatment.
Many men find complaints “down there” embarrassing and are ashamed to go to the doctor. Throw this shame overboard. Doctors are familiar with a wide range of conditions, and you are neither the first nor the last man to visit the emergency services with priapism.
This also applies if you have taken illegal substances such as cocaine. The doctor’s job is to help you, not judge you. Call the above-mentioned number 116117 for quick medical assistance and an assessment of your situation.
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