Priapism

What is Priapism?

Priapism is a persistent, unwanted erection of the penis.

Priapism may occur in one of the following ways:  

1. There may be repeated, reversible painful erections occurring over several hours (penis becomes erect then erection goes away, then becomes erect again, then erection goes away, etc.) This is also called "stuttering" priapism. There is not a problem with sexual functioning once the episode has gotten better. Repeated episodes of this type of priapism are common and occur in up to 40% of patients.

   This type of priapism can usually be managed at home. Patients are encouraged to take warm baths, increase fluid intake and empty their bladder (urinate) often. If the episode is not better after three hours, notify the doctor. Take Tylenol for pain.

2. There may be a prolonged, painful erection that does not go away for more than several hours. This can last for up to several days or weeks.

   This type of priapism needs attention by a doctor. Without medical treatment, severe priapism can lead to partial or complete impotence in over 80% of cases. Sometimes a blood transfusion is given during the attack.

3. Persistent penile enlargement or hardening that may last for weeks to years; this type of priapism is usually painless. It usually develops after a long episode of priapism (as described in #2 above). Sexual functioning is often impaired (for example-impotence).

What causes these attacks?

Specific causes of priapism in patients with sickle cell anemia are unknown. Acute attacks often begin during sleep or following sexual activity, but frequently there is no identifiable event or cause.

Prevention

There is no current program or therapy to prevent attacks of priapism. There is not a way of predicting who will develop priapism and impotence. Patients with repeated attacks are encouraged to avoid long periods of bladder distention (not urinating for long periods of time), dehydration, and extended sexual activities.