Priapism
Priapism is a painful, persistent erection unaccompanied by sexual desire or excitement.
Priapism probably results from abnormalities of the blood vessels and nerves that cause blood to become trapped in the erectile tissue (corpora cavernosa) of the penis. In most cases, priapism is caused by drugs taken by mouth or injected into the penis to cause erection. Other known causes of priapism include blood clots, leukemia, sickle cell disease, a tumor in the pelvis, and an injury to the spinal cord. Sometimes, however, no cause can be found.
Several symptoms help differentiate priapism from normal erections. Priapism lasts longer, usually several hours. Sexual excitement does not accompany priapism, and the erection is painful. Also, in priapism, the glans penis may be soft.
The treatment of priapism depends on the cause. Any drug that appears to cause the priapism is discontinued immediately. Injection into the penis of a drug that decreases erection (for example, epinephrine, phenylephrine, terbutaline, or ephedrine) can relieve priapism caused by penile drug injection. Spinal anesthesia may relieve priapism caused by a spinal cord injury. If a blood clot is the probable cause, surgery to remove the clot or restore normal circulation in the penis is necessary. Usually, if other treatments are ineffective, priapism can be treated by draining excess blood from the penis with a needle and syringe and using fluid to wash out any blood clots or other blockages from the blood vessels. One or more of many possible drugs may also be used, depending on the underlying cause. Prolonged priapism usually impairs erectile function permanently.
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