Priapismus
Priapism is a condition when a man experiences a prolonged erection without sexual stimulation. Erections can last up to more than 4 hours and often cause pain.
Causes of Priapismus
In people with priapism, erections are not triggered by sexual stimulation. This condition occurs when there is an interruption in blood flow in the penis. The cause of priapism is not yet known with certainty, but priapism is divided into two types, with different symptoms and treatments. The two types are ischemic priapism and non-epidemic priapism.
Ischemic Priapism
Ischemic priapism occurs when the blood vessels of the penis become blocked, thereby preventing blood from flowing and accumulating in the penis. This type of priapism is the most common and recurrent type of priapism, especially in patients with sickle cell disease.
Certain conditions that can trigger ischemic priapism, namely:
Non-epidemic priapism
Non-ischemic priapism occurs when the blood vessels of the penis are torn or ruptured, resulting in excessive blood flow to the penis. This condition can be caused by injuries to the penis, pelvis and perineum, the area between the penis and anus.
In addition, there are several other factors that can trigger non-endemic priapism, namely:
Symptoms of Priapismus
Symptoms that appear depend on the type of priapism experienced by the patient. If the patient has ischemic priapism, symptoms may include:
Non-epidemic priapism has symptoms that are almost similar to ischemic priapism. However, the difference lies in the fact that priapism-free patients do not feel pain and the penis shaft is not completely rigid.
If the erection lasts more than 4 hours, immediately consult a doctor for emergency treatment, because this condition can cause permanent complications.
Priapism diagnosis
Priapism can be an emergency, so the doctor will examine it quickly and take action to prevent complications that may arise. If necessary, analysis of blood gas taken directly from the penile blood vessels or penile ultrasonography is needed to determine the type of priapism.
If temporary priapism is resolved, the doctor will determine the factors that trigger priapism. Further investigation will be needed to detect the cause of priapism and further treatment will be needed to prevent a recurrence. Additional types of checks that can be performed include:
Blood test to measure the number of red blood cells and platelets. With this examination, the doctor can identify abnormalities or diseases that are suspected to be causes of priapism, such as sickle cell disease.
Toxicological test, intended to detect the content of drugs that cause priapism, through urine samples.
Penile ultrasonography, in addition to measuring blood flow in the penis and determining the type of priapism, penile ultrasonography can detect injuries or abnormalities that cause priapism.
Pripapism treatment
Priapism treatment steps are based on the type of priapism experienced by the patient. Non-epidemic priapism usually resolves on its own without going through several treatment procedures. Initial treatment to relieve erections can be done alone at home. The initial treatment steps include:
If the erection does not improve, immediately consult a doctor, you may experience ischemic priapism, which must be treated by a doctor.
If priapism is caused by an injury, surgical procedures are sometimes performed to repair damaged blood vessels or penile tissue. In addition, surgery can also be done by inserting materials, such as gels, to temporarily block blood flow to your penis.
For ischemic priapism, the treatment actions taken are as follows:
Complications of Priapismus
Ischemic priapism can cause serious complications if not treated immediately. Blood trapped when the penis has a prolonged erection, will experience lack of oxygen. Oxygen-deprived blood can damage or destroy penile tissue. If left unchecked, this condition can cause erectile dysfunction.
Penile or pelvic lesions that cause non-diskemic priapism can also cause penile tissue infections.
Prevention of priapism
The main preventive measure against priapism is the treatment of diseases that cause priapism, for example the treatment of sickle cell disease. In addition, several types of drugs can be used to prevent recurrent attacks of priapism, namely:
In people with priapism, erections are not triggered by sexual stimulation. This condition occurs when there is an interruption in blood flow in the penis. The cause of priapism is not yet known with certainty, but priapism is divided into two types, with different symptoms and treatments. The two types are ischemic priapism and non-epidemic priapism.
Ischemic Priapism
Ischemic priapism occurs when the blood vessels of the penis become blocked, thereby preventing blood from flowing and accumulating in the penis. This type of priapism is the most common and recurrent type of priapism, especially in patients with sickle cell disease.
Certain conditions that can trigger ischemic priapism, namely:
- Suffer from diseases such as sickle cell disease, leukemia, thalassemia and multiple myeloma.
- Take medicine, such as:
- Anticoagulant drugs, such as warfarin and heparin.
- Antidepressants, such as fluoxetine, bupropion, and sertraline.
- Medications for prostate enlargement, such as terazosin, doxazosin and tamsulosin.
- Drugs that can be injected for erectile dysfunction, such as papaverine.
- Medications to treat mental disorders, such as risperidone, olanzapine and clozapine.
- Hormone therapy, such as testosterone and gonadotropin-releasing hormone (GnRH).
- Medications to treat ADHD, such as atomoxetine.
- Excessive alcohol and drug abuse.
Non-epidemic priapism
Non-ischemic priapism occurs when the blood vessels of the penis are torn or ruptured, resulting in excessive blood flow to the penis. This condition can be caused by injuries to the penis, pelvis and perineum, the area between the penis and anus.
In addition, there are several other factors that can trigger non-endemic priapism, namely:
- Metabolic disorders, such as amyloidosis.
- Nerve disorders
- Cancer is located near the penis, such as prostate cancer and bladder cancer.
- Bite or scorpion.
Symptoms of Priapismus
Symptoms that appear depend on the type of priapism experienced by the patient. If the patient has ischemic priapism, symptoms may include:
- Pain that gradually increases in the penis.
- Erections that last more than 4 hours.
- The shaft of the penis is stiff with a soft tip.
Non-epidemic priapism has symptoms that are almost similar to ischemic priapism. However, the difference lies in the fact that priapism-free patients do not feel pain and the penis shaft is not completely rigid.
If the erection lasts more than 4 hours, immediately consult a doctor for emergency treatment, because this condition can cause permanent complications.
Priapism diagnosis
Priapism can be an emergency, so the doctor will examine it quickly and take action to prevent complications that may arise. If necessary, analysis of blood gas taken directly from the penile blood vessels or penile ultrasonography is needed to determine the type of priapism.
If temporary priapism is resolved, the doctor will determine the factors that trigger priapism. Further investigation will be needed to detect the cause of priapism and further treatment will be needed to prevent a recurrence. Additional types of checks that can be performed include:
Blood test to measure the number of red blood cells and platelets. With this examination, the doctor can identify abnormalities or diseases that are suspected to be causes of priapism, such as sickle cell disease.
Toxicological test, intended to detect the content of drugs that cause priapism, through urine samples.
Penile ultrasonography, in addition to measuring blood flow in the penis and determining the type of priapism, penile ultrasonography can detect injuries or abnormalities that cause priapism.
Pripapism treatment
Priapism treatment steps are based on the type of priapism experienced by the patient. Non-epidemic priapism usually resolves on its own without going through several treatment procedures. Initial treatment to relieve erections can be done alone at home. The initial treatment steps include:
- Increase fluid consumption.
- Try urinating.
- Soak in warm water.
- Do moderate exercise, such as walking or running calmly on the spot.
- Take pain relievers, such as paracetamol, if necessary.
If the erection does not improve, immediately consult a doctor, you may experience ischemic priapism, which must be treated by a doctor.
If priapism is caused by an injury, surgical procedures are sometimes performed to repair damaged blood vessels or penile tissue. In addition, surgery can also be done by inserting materials, such as gels, to temporarily block blood flow to your penis.
For ischemic priapism, the treatment actions taken are as follows:
- Drug treatment Stimulating drugs that regulate blood vessels, such as phenylephrine. This drug is given by injection directly into the penis and the dose can be repeated, if necessary.
- Excretion of blood that has accumulated in the penis. By using a small needle, the accumulated blood will be removed until the erection subsides. After the action is complete, the penis will be cleaned with sterile liquid.
- Surgery is performed by changing the way blood flow to the penis. Surgery is performed if other treatments are considered ineffective for treating ischemic priapism.
Complications of Priapismus
Ischemic priapism can cause serious complications if not treated immediately. Blood trapped when the penis has a prolonged erection, will experience lack of oxygen. Oxygen-deprived blood can damage or destroy penile tissue. If left unchecked, this condition can cause erectile dysfunction.
Penile or pelvic lesions that cause non-diskemic priapism can also cause penile tissue infections.
Prevention of priapism
The main preventive measure against priapism is the treatment of diseases that cause priapism, for example the treatment of sickle cell disease. In addition, several types of drugs can be used to prevent recurrent attacks of priapism, namely:
- Tablets or phenylephrine injections.
- Take medication for erectile dysfunction, such as sildenafil or tadalafil.
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