Priapism is a painful erection that lasts for several hours. It develops when blood remains in your penis and can’t drain. It can occur without cause, or it may result from an underlying condition, nonmedical use of medications or injury. It requires immediate medical treatment to prevent permanent damage to your penis.
Priapism is a long-lasting erection that occurs without sexual arousal or stimulation. It’s usually painful and it can last for more than four hours. It occurs when blood remains in your penis and can’t drain.
Priapism needs immediate treatment. Without treatment, it can cause permanent damage.
The types of priapism include:
Priapism is relatively rare overall, but you may be more likely to have it if you have certain conditions. It occurs in 30% to 45% of people with sickle cell disease.
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The main symptom of priapism is a prolonged erection, usually lasting longer than four hours without sexual arousal or stimulation. Other symptoms depend on the type of priapism you have.
If you have low-flow priapism, your symptoms may also include:
If you have high-flow priapism, your symptoms may also include:
Up to 33% of all priapism cases don’t have a known cause.
Low-flow priapism causes may include an underlying health condition, including:
No, priapism isn’t contagious. It isn’t a sexually transmitted infection (STI) or STI symptom.
Priapism can occur in anyone with a penis in all age groups, including (very rarely) newborns. However, it most commonly affects two different age groups:
Without treatment, priapism can permanently damage your penis. Your blood contains oxygen, which the cells in your body use to create energy. If you have priapism, the trapped blood eventually runs out of oxygen, which can harm the tissues in your penis. Untreated priapism can cause:
If you have an erection that lasts longer than a few hours, it’s important to get medical care immediately. A healthcare provider will review your medical history, note your symptoms and conduct a physical examination. During the physical exam, they may ask the following questions:
After the physical exam, the provider will measure the blood oxygen level in your penis. During this test, they’ll insert a small needle into your penis to withdraw a tiny amount of blood. They’ll send the blood sample to a lab for analysis. The lab results will tell the provider:
If an injury causes priapism, the provider may order a Doppler ultrasound. A Doppler ultrasound uses sound waves to show where and how fast blood flows through your blood vessels. It helps confirm that an injury is the cause of your priapism.
In some cases, a provider may order a drug test (toxicology screen). A drug test helps determine what substances and the approximate amount you have in your system.
The goal of all priapism treatment is to make your erection go away and preserve your ability to have erections in the future. If you think you have priapism, don’t attempt to treat it yourself. Get emergency help as soon as possible.
A healthcare provider may initially give you decongestants, such as phenylephrine (Sudafed PE®). They can help decrease your erection by reducing blood flow to your penis. Decongestants are most effective within four to six hours after first developing priapism.
Other treatment options include:
A painful erection can make you feel self-conscious or embarrassed, and you may think you can try some of these treatment options at home first. However, it’s important to see a provider as quickly as possible if you have priapism symptoms.
If an underlying condition causes priapism, you may receive other treatments.
No, masturbating or having sexual intercourse usually won’t make priapism go away even if you ejaculate.
If the treatment is effective, it should fix your priapism immediately. You may experience relief with the first treatment, or you may need more than one treatment if the priapism doesn’t go away at first. After the priapism is treated, your penis may be sore and feel swollen, but it shouldn’t be rigid.
It’s important to remember that your body is unique. Your recovery time may vary. Follow your provider’s instructions on managing pain or discomfort as you recover.
The following tips may help prevent priapism:
High-flow priapism may go away on its own without treatment within hours to weeks.
Low-flow priapism doesn’t go away without treatment.
As long as you get treatment quickly, the outlook for most people is good.
About half of people with low flow priapism can still achieve an erection if they can reverse priapism within 24 hours. If you have low-flow priapism for more than 36 hours, you’ll likely have scarring and permanent erectile dysfunction.
The following tips may help reduce your erection and relieve pain early on:
Talk to a healthcare provider if you get recurrent painful erections without sexual arousal or stimulation that go away on their own.
After treatment, schedule a follow-up appointment with your healthcare provider. Call your provider right away if priapism comes back after treatment.
Priapism is a medical emergency. If you have an erection without sexual arousal or stimulation that doesn’t go away within a few hours, go to the emergency room immediately. The longer you wait, the greater your risk of permanent damage to your penis.
Yes, you can get priapism while you’re sleeping. Getting erections while you sleep is normal (nocturnal penile tumescence). However, priapism pain will wake you up. It usually won’t go away, and it’s difficult to go back to sleep.
A note from Cleveland Clinic
Priapism needs immediate treatment to prevent permanent damage to your penis. An erection that won’t go away can be embarrassing. However, priapism is different than a typical erection. It appears without any arousal or stimulation, and it hurts. This is your body’s way of telling you that something is wrong. Talk to a healthcare provider as quickly as possible to increase your chances of avoiding permanent damage to your penis.
Last reviewed by a Cleveland Clinic medical professional on 05/08/2023.
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