Priapism is an erectile dysfunction that will result in a long erection (sometimes more than 4 hours and painful) and especially that will never end in ejaculation.This disorder quite common among men of forty years can have serious consequences on your sexual life, if it is not treated in time.We explain to you how to detect it, what are the causes.
What is priapism?
Before looking at the causes of priapism, it is important to understand the type you are suffering from. Indeed, this erection disorder can manifest itself in different ways. And the treatments to treat it will be in this case very specific. The care according to the form of priapism you suffer should also be done more or less urgently.
We must therefore distinguish:
- Ischemic priapism . This is the most common form of priapism. It is characterized by a very weak blood circulation. Your penis will usually be very stiff, but your erection will cause very severe pain (due to asphyxiation of the muscle fibers of the cavernous body of your penis). If you think you are suffering from ischemic priapism, it is crucial that you consult a doctor as soon as possible to avoid potential complications.
- The nonischemic priapism . This time, you will have a higher blood flow and your erection will be less painful. And especially less rigid. You can also observe arterial blood leaks. Your penis will be filled with oxygenated blood. In 60% of cases, no treatment will be necessary and you will be cured spontaneously. But if you are still erect after 4 hours, it will be urgent to see a doctor to get everything back in order.
- Recurrent priapism . You will have in this case a recurrent and intermittent erection. Most often, this form of erection disorder will be treated through hormonal therapy.
Some physicians will talk about low-throughput priapism (not ischemic priapism) and high-throughput priapism (instead of the non-ischemic form).
What are the symptoms of priapism?
Priapism is quite simple to diagnose because it is characterized by the concomitance of three main symptoms.
- Your erection will be abnormally long (several hours).
- You will feel significant pain (even if it is not always the case).
- The absence of ejaculation following your erection
- You can also observe that your glans will not be inflated (even in erection) and will remain soft.
You may suffer from priapism if your erections are:
- Permanent : The duration of your erection is an excellent indicator of your erectile health. It is also the length of your erections that will diagnose most often a case of priapism. And it is the one that is most commonly shared by the different forms of priapism. So if you’re stroking for more than 4 hours, your first reflex should be to see a doctor. Whether your erection is accompanied by pain or not.
- Involuntary : To know if you suffer from priapism, it is also important to ask yourself what is the origin of your erection. If it is uncontrolled (that is, it does not result from sexual stimulation), you may be suffering from this erectile disorder. This will be the case, for example, if you have a new erection after a report, or in your sleep (especially if it lasts a long time).
- Painful : it is perfectly possible to have a prolonged erection without it being accompanied by pain. This is the case for example if you take treatments against impotence. But also if you suffer from high-rate priapism. Pain is therefore a rather treacherous indicator, since it will not occur in all cases. However, it will make the difference between a case of urgent priapism (low flow) or not.
What are the possible causes of this erectile dysfunction?
The main cause of a case of priapism will be a disorder related to the circulation of your blood. And especially :
- the formation of a clot in your arteries;
- sickle cell disease: this genetic condition will affect your red blood cells;
- some cases of leukemia, cancers, but also disorders of coagulation;
- disorders of blood drainage through the veins of the cavernous body of your sex;
- myeloproliferative disorder.
Priapism will also often be brought about by taking medical treatment. And especially :
- treatments for hypertension (such as beta-blockers)
- antidepressants (such as trazodone) and anxiolytics;
- some treatments against erectile dysfunction (including Viagra). But also the papaverine injections that are most often used to treat a case of male impotence. Less used since the sale of iPDE5, stimulants are rarely the cause of priapism but should not be discarded;
- a penis ring too tight;
Your priapism can also be caused by an injury (especially if you ride a bar or hit your bike). Or be the logical result of a trauma in your perineum.
However, in one out of three cases, the origin of your priapism will be impossible to determine. It may indeed result from stimulation too long. But also stress or anxiety related to your performance. A urinary infection can also be involved. As well as the consumption of certain toxic substances (in particular alcohol, tobacco and drugs).
How to treat priapism effectively and sustainably?
Depending on the origin of your priapism, the treatments that can advise you your doctor will be significantly different. Here are the most effective ones, and the cases in which they apply.
What you can do during the first hours
It is possible to pass your priapism on your own during the first hours of your erection. For example, you can run or walk quickly to create a call to your bloodstream that will empty the cavernous body of your penis.
You can also spend your sex under a stream of cold water or apply ice cubes (protected in a small towel). If you can not disband after 4 hours, it will be necessary to consult a doctor. Especially to avoid permanent lesions and thus erectile dysfunction in the long term.
Diagnosis by a professional
A precise diagnosis will then be necessary to determine the best treatment to treat your priapism. Your doctor will perform a puncture to analyze the gases in your blood and check its oxygenation rate. If it is high, then it will be necessary to intervene urgently.
The different treatments possible
Thereafter, your doctor may start by prescribing alpha stimulant medications. Ingested orally or injected locally, they induce vasoconstriction of the cavernous body of your sex within 24 hours.
If this first intervention is not enough to treat your priapism, he can then proceed to a puncture to empty your sex of his blood . As a last resort, he can also perform, assisted by an urologist) a shunt or a bypass. This will make circulate the blood lodged in your cavernous body to the penis.
The latter is indeed composed of spongy tissue that will allow to evacuate blood and excessive pressure. This procedure will be done most often under general anesthesia). And in case of high-speed priapism, the latter may instead use a plug (made via ligation or compression) to reduce the leak.
In the most severe cases, surgery will be necessary. This is especially essential if your priapism lasts more than 48 hours. It will help to drain the blood stuck in your cavernous body. But it must be practiced as quickly as possible, to avoid possible complications and sequelae.
Your doctor will puncture your cavernous body. Then, he will carry out a washing using a physiological saline and will inject to finish an alphastimulant (most of the Effortil). However, be careful to avoid adrenaline injections that can lead to serious complications and suddenly stop the circulation of your blood.
The penile prosthesis
The treatment of your priapism can unfortunately lead to problems of impotence. In this case, your doctor can advise you to put a prosthetic penis. It will help to inflate and deflate your sex to order, and thus avoid erectile dysfunction.
A perforation of your cavernous body (because they are fibrous) will be necessary to help them regain their elasticity. After perforation, it will introduce prostheses properly speaking, which are often made of plastic.
To act as quickly as possible?
The treatment of your priapism and the attitude to adopt will depend largely on the frequency of your erection problems. Indeed, a rapid intervention will be necessary only if it is not an isolated case, but intermittent accidents. Indeed, if you have prolonged erections during the night or that are uncomfortable and difficult to control during the day, it is essential to consult a professional to avoid the destruction of your cavernous tissue. Because such a complication can make you impotent .
Indeed, the detumescence of your penis, which can occur after an episode of priapism can cause a definitive impotence. Your tissues will have lost their elasticity, and they will no longer be able to stretch (a necessary phenomenon for you to bend). And in this case, only the installation of a prosthesis will prove effective.