Priapism is an uncommon condition that causes an erection that lasts far longer than normal—often for four hours or more. It may start as a regular erection when you’re sexually aroused. Or, it can pop up without any stimulation. The erection can last for several hours and can be very painful. If priapism isn’t treated, it can cause erectile dysfunction and scarring. Priapism is most common in men ages 5 to 10 and 20 to 50. It can be associated with certain medical conditions such as sickle cell disease, pelvic tumors, pelvic infections, Leukemia, genital trauma or spinal cord trauma. Certain medication or recreation drugs can be a trigger. A third of the cases will have unknown causes.
Priapism is classified into two types — ischemic (no-flow) or non-ischemic (high-flow).
Diagnosis of Ischemic and Non-Ischemic
Diagnosis involves a medical history and examination to determine any underlying medical causes and the duration of the condition. During the medical examination, your doctor will assess the severity of pain, the rigidity of the penis and lack of involvement of certain parts of the penis. This also will include checking the rectum and the abdomen for evidence of unusual growths or abnormalities that may indicate the presence of cancer. In addition, a sample of your blood will be analyzed to exclude sickle cell disease, thalassemia major, and leukemia.
Diagnosis of non-ischemic priapism also involves a medical history and examination to determine any underlying medical causes and duration of the condition. In addition, your doctor will conduct a Doppler examination, which measures the blood flow to your penis.
When in doubt, a small needle may be placed in the penis to draw some blood, which is then sent to a lab for analysis. This will help determine which type of priapism the patient is experiencing.
Dr. Shoengold is a leading expert in the field of men’s sexual health. Schedule your consultation evaluation today 973-218-9400.