What is priapism?

Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and is unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.

Priapism can occur in all age groups, including newborns. However, it usually affects men in two different age groups: between the ages of 5 and 10, and 20 and 50.

There are two types of priapism: low-flow and high-flow.

  • Low-flow priapism: This is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but it also affects men with sickle-cell disease, leukemia (cancer of the blood), or malaria.
  • High-flow priapism: This is more rare and is usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (the area between the scrotum and anus), which prevents blood in the penis from circulating normally.

What causes priapism?

  • Sickle cell anemia: Some adult cases of priapism are the result of sickle-cell disease. Approximately 42% of all adults with sickle-cell will eventually develop priapism.
  • Medications: A common cause of priapism is the use and/or misuse of medications, including drugs such as Desyrel (used to treat depression or as a sleeping aid) or Thorazine (used to treat certain mental illnesses). For people who have erectile dysfunction, injection therapy medications to treat the condition may also cause priapism.

Other causes of priapism include:

  • Trauma to the spinal cord or to the genital area
  • Black widow spider bites
  • Carbon monoxide poisoning
  • Illicit drug use, such as marijuana and cocaine

In rare cases, priapism may be related to cancers that can affect the penis and prevent the outflow of blood.

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