Priapism is a rare pathology, manifested by a prolonged erection that occurs without any sexual arousal. This syndrome of permanent genital arousal, beyond causing sensations of pain and discomfort, can have serious consequences. This is why it is important to remedy it as soon as the PSAS occurs.

PSAS is a rare and generally one-off pathology. It is common to mention priapism for men. However, although less widespread, the syndrome of permanent genital arousal also affects women: it is clitoral priapism or clitorism.

Priapism, a painful and prolonged erection of the penis

In men, erection is in principle the consequence of sexual desire. It can also occur after taking drugs such as viagra. But it happens that the man “undergoes” an uncontrollable and sudden erection, without any form of excitement and without having taken any medication. It is then a manifestation of priapism. The flow of blood into the man’s penis lasts several hours, and does not give rise to ejaculation. In the event of ejaculation, moreover, the erection is not thereby attenuated. This pathology, beyond being very annoying since it surprises the man in a sometimes inappropriate situation to have an erection, causes significant and prolonged physical pain.

Clitorism, female priapism

Priapism in men is rare, female priapism even more so. The symptoms are the same as in men, but are observed in the clitoris: when erect, this organ swells with blood significantly and lastingly, without prior sexual stimuli. Female priapism also causes pain and discomfort. 

If the causes of female priapism remain to this day poorly understood, various factors are recognized as promoting the syndrome of permanent genital arousal in men. First risk factor for PSAS: taking certain drugs and toxic substances. Drugs to stimulate the erection – such as Viagra – but also antidepressants, corticosteroids, tranquilizers or certain drugs can be the cause of an uncontrollable and prolonged erection. To the extent that PSAS manifests itself as an inordinate amount of blood and occurs under inappropriate circumstances, priapism can also be the result of a blood disease – sickle cell anemia or leukemia in particular. Psychological trauma, shock in the perineal area or misuse of sex toys… other factors have been put forward to explain the occurrence of priapism in men.

Depending on the nature of priapism, treatment and urgency may not be the same.

Low flow priapisms

Low-flow priapism – or ishemic priapism – is the most common case of permanent genital arousal syndrome. Despite a low blood flow, the blood that is not evacuated causes strong pressure which manifests itself in a very rigid and all the more painful erection. This form of PSAS is the most serious and the most urgent: beyond the discomfort felt, priapism can in this context result in more or less significant erectile disorders – going as far as permanent impotence. This is why it is essential to consult as quickly as possible. Priapism is then managed with a puncture, drug injection, or surgery if basic procedures fail.

High-speed priapisms

Much rarer, non-ishemic priapism is less painful, especially because it causes an erection that is less rigid and more ephemeral. This form of permanent genital arousal syndrome can also disappear without treatment and does not present the medical emergency character of low flow priapism: in most cases, the erection disappears without intervention.

In any case, the man who observes a syndrome of permanent genital arousal can ensure initially to use basic solutions to stop the erection: cold shower and active walking in particular. After several hours of a painful erection, it becomes urgent to consult a urologist, at the risk of priapism having serious and irreversible consequences on erectile function.