Thus, among children with SCD, the rate of pediatric priapism is about 25% to 30%. While pain is usually felt at the time of the fracture, on rare occasions, a person may only experience pain later when they have an erection or sex. PD can cause pain during erections due to stretching of the shortened membranes. Depending on the severity of PD, the pain may be felt when getting an erection or only during sexual intercourse. Some people with PD may also feel pain when the penis is flaccid (soft). A recent small study reported daily dutasteride therapy as a promising treatment option to reduce the frequency and severity of the painful episodes without significant side effects31.
If you are experiencing an erection that lasts for hours, it is important to seek medical attention immediately. This condition, known as priapism, can be painful and potentially dangerous if left untreated. Priapism occurs when blood becomes trapped in the penis, leading to prolonged erections that can last for more than four hours.
Terbutaline, a β2 adrenergic agonist, has long been recommended for preventing recurrent episodes of stuttering priapism. The dosage of oral terbutaline is 5 mg immediately, with another 5 mg taken 15 minutes later. Recent questioning of the role of terbutaline due to the lack of proven efficacy in acute priapism has led to its current non-recommendation. In general, treat acute priapism in patients with frequent recurrences is the same as those without such recurrences. This report will focus on treatment and prophylactic therapies for stuttering priapism.
Symptoms of Priapism
The main symptom of priapism is a persistent erection that lasts for hours without sexual stimulation. Other symptoms may include:
Priapism is often caused by the use of certain medications, including antipsychotics. An erection begins with sensory and mental stimulation in your brain. Don’t stop taking any prescription medications without consulting your doctor. No, masturbating or having sexual intercourse usually won’t make priapism go away even if you ejaculate. In some cases, a person may not need to see their doctor for erection troubles.
Ischemic priapism — the result of blood not being able to exit the penis — is an emergency situation that requires immediate treatment. After pain relief, this treatment usually begins with a combination of draining blood from the penis and using medications. If an injury causes priapism, the provider may order a Doppler ultrasound.
One such example is a rare tumor called an epithelioid hemangioma which typically causes a painless tumor around the head or neck. Cases have been known to occur within the blood vessels of the penis. During an erection, the tumor can suddenly press on a nearby nerve and trigger acute pain or discomfort. The cause of SRPE is unclear, but most studies suggest that obstructive sleep apnea (OSA) plays a central role. It is thought gaps in breathing spurred by OSA may increase blood flow to the penis and stimulate the production of chemicals called neurotransmitters that may amplify a person’s sensitivity to pain. Certain sexual positions can cause a penile fracture by colliding the erect penis against the bony structures of the pelvis.
The best way to keep your penis healthy, though, is to keep an eye out for problems and have them checked out by a doctor as soon as possible—the sooner the better. When an erection lasts for too long — usually more than four hours — this lack of oxygen can begin to damage or destroy tissues in the penis. Identifying and finding a solution to the root cause of erectile dysfunction may help your penis make a return to its former glory. However, if you are unable to find your own solution, you may need to consult a doctor to undergo a thorough diagnosis and receive the safest, most appropriate treatment. Remember that sexual problems are nothing to be ashamed about, and should not be hidden away. There are multiple options for hormone treatment for patients with stuttering priapism, but they all aim to reduce the circulating testosterone levels.
- Pain or tenderness in the penis
- Swelling or firmness of the penis
- Difficulty urinating
Nevertheless, several experts recommend consideration of this therapy when all other treatments have been unsuccessful and as an alternative to proceeding to a penile prosthesis with its irreversible sequelae. This type of priapism is the most common of the two and occurs when the blood can’t exit the penis. Although the pathophysiology of stuttering priapism is not fully understood, it appears to result from dysregulated dynamics of the normal erection process, leading to venous stasis, compartment syndrome, and diminished blood flow. This process eventually leads to tissue damage and, ultimately, corporal fibrosis with permanent loss of erectile ability.
Causes of Priapism
There are several potential causes of priapism, including:
- Medication side effects, such as certain antidepressants or blood thinners
- Medical conditions, such as sickle cell disease or leukemia
- Trauma to the genital area
Treatment Options
If you are experiencing priapism, it is crucial to seek medical attention as soon as possible. Treatment options may include:
- Medications to help reduce blood flow to the penis
- Draining the blood from the penis with a needle
- Surgery to correct any underlying issues causing the priapism
Frequently Asked Questions
Q: Is priapism a common condition?
A: Priapism is relatively rare but can occur in men of all ages.
Q: Can priapism cause permanent damage?
A: If left untreated, priapism can lead to permanent damage to the penis and erectile dysfunction.
