Priapism (snuff), constant erection

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Priapos was the god of fertility and fertility. His statue depicted a man with a powerful erected member. So it is clear why an erection disorder was named after him. But where does the second name of this ailment come from? The only attraction of men affected by priapism is to get rid of the erection immediately.

Longer doesn’t mean better

Although adepts of tantric sex persistently strive to maintain an erection for hours, those who are given it just like that, that is, victims of priapism, have no reason to be happy. On the contrary, quite a lot to worry about.

– Priapism is a dramatic disease. Untreated, it can lead to permanent impotence, and in extreme cases to necrosis of the penis and may even require its amputation. Therefore, any erection that lasts longer than physiological should immediately be on urological emergency room – warns Piotr Szulc, urologist, head of the Urology Department at the EuroMediCare Specialist Hospital in Wrocław.

There are two main types of priapism: low-flow, or ischemic, and high-flow, or hyperemic, priapism.

The latter is usually caused by a blunt trauma to the genitals, e.g. a strong ball hit. However, because the effect of persistent erection is not immediate, it may appear even several days after the injury, and is often not associated with trauma. While there are medical grounds to consider it less dangerous, and at least not obligatory for immediate action, as in the case of low-flow priapism, it is not an exception to the rule of immediate contact with a doctor for an erection lasting longer than 4-6 hours. Injuries account for roughly 12% of all priapism, which is very rare, with an average of one in a hundred men each year. The tireless, but exhausting erection is also a fairly common complication after injection treatment of impotence, i.e. topical injections. Note – over time, this type of priapism changes from hyperemic, to ischemic, more dangerous!

Any faster

Low-flow priapism is more frequent and dangerous. It also has a more complex pathogenesis.

The triggering factors are threefold. About 20% of cases are caused by the medication taken by the man. The risk group includes psychotropic, antihypertensive and cardiac drugs. Alcohol is also an important cause. About 10% of cases are prolonged erections caused by a disease, most often sickle cell anemia, less often leukemia. Priapism can also be caused by cancer metastasis to the penis. However, the vast majority of cases are so-called idiopathic priapisms, that is, those whose cause remains unclear.

In the case of low-flow priapism, also known as ischemic priapism, literally every hour that brings the patient closer to the hospital bed counts. Time matters so much, because, as the name suggests, in this type of thrust, the blood supply to the penis is difficult. Fibrosis of the corpus cavernosum in the penis occurs after four hours, after twelve the lesions become permanent, and after 24 hours the irreversible process of necrosis begins.

Rinse and a large needle

These two types of priapism differ not only in cause but also in their course. High-flow drag, the one caused by trauma, is not painful and passes by itself in more than half of the cases without the need for intervention (which does not mean that without medical supervision!). In young boys, you can try to compress the perineum, which sometimes leads to the erection subsiding. Low-flow priapism is always painful, and the pain is sometimes excruciating. Erection affects only the corpus cavernosum, so e.g. the glans of the penis remains flaccid. The color of the penis also changes: first it is bluish, then purple-violet. The change in color may be accompanied by swelling.

There are many methods of treatment, ranging from non-invasive ones that can be used even at home:

– Temporarily put ice on the penis, or administer sedatives. After differentiating the types of priapism, already in hospital conditions, in the case of low-flow priapism, aspiration is first used, i.e. taking blood from corpora cavernosa, and then rinsing them with physiological saline – explains Piotr Szulc, urologist. – If this does not work, it’s time to use a large needle to pierce the penile structures along the urethra, and then insert the so-called shunty, or anastomosis. The point is that the bad, unoxidized blood can drain from the corpora cavernosa. Unfortunately, this and similar treatments carry a high risk of complete impotence.

In the name of urgency

Hyperemic priapism, if it does not resolve spontaneously, is treated with local injections, oral medications, and in cases of extremely complicated injuries, the damaged artery is embolized, i.e. the hole is patched. Synthetic materials or a patient’s blood clot are used as patches. As a last resort, a more complicated ligation of the damaged artery is used.

Unfortunately, there are cases of priapism that are extremely resistant to treatment. Paradoxically, unsuccessful treatment of an erection that lasts many hours results in complete impotence. It will affect 90% of men who have an erection lasting more than a day. Therefore, after the biopsy of corpora cavernosa and finding necrosis, it is worth considering immediate implantation of prostheses into them. Over time this will become more and more difficult as the tissue will undergo a continuous process of fibrosis.

Gentlemen must remember to watch their erections carefully and to look at those prolonged ones, and not necessarily to be proud of their masculinity. Each case of priapism should be consulted with a specialist doctor, because there is a lot to lose. The god of fertility and fertility patronizes the disease, which can end in permanent and complete impotence, so that the thistle does not deprive the chances of smaller and greater urges, you should present the doctor every disturbing episode of erection.

Text: Julia Wolin

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