Publisher: Kenneth Kee
Publication Date: January 26, 2017
Binding: Kobo eBook
Priapism is a prolonged erection of the penis which is usually painful and lasts more than 4 hours.
It is not necessarily related with sexual desire or excitement and does not subside after ejaculation
Priapism may occur by itself or caused by medical treatment (iatrogenic) and can occur in all age groups including newborns.
It usually affects men between the ages of 5 to 10 years and 20 to 50 years.
There are two types of priapism:
1. The low flow priapism is the result of blood being stuck in the erection chambers.
Low flow priapism usually occurs without a known cause in men who are otherwise healthy but also affects men with sickle cell disease, leukemia (cancer of the blood) or malaria.
2. High-flow priapism is less common than low-flow and usually not painful.
It occurs from a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus) which prevents blood in the penis from circulating normally.
Medically the condition is associated with high blood flow when there is little risk of tissue damage or low blood flow when the risk of damage is higher.
Some 35 per cent of cases are idiopathic (unknown cause) and 21 per cent are associated with drug therapy or alcohol abuse.
Injury accounts for 21 per cent and blood disorders 8 per cent.
A painful erection that lasts for longer than four hours requires treatment in hospital.
Many cases resolve spontaneously after repeated ejaculation, physical activity or a brisk walk.
Oral terbutaline (e.g. Bricanyl) or salbutamol (e.g. Ventolin) may help if given early.
Blood (50ml) can be removed by a doctor inserting a large bore (19G+) needle into the penis often in conjunction with heparin and saline to reduce clotting.
In resistant cases, a reversing agent, metaraminol (1 per cent solution), may be injected into the penis.
Rarely surgery is required to avoid permanent damage to the muscle of the ...