Erectile Dysfunction and Priapism

Erections can’t happen without proper blood flow. Normally when a man gets aroused, the arteries in their pelvis and penis relax and expand, bringing more blood to spongy tissues in the penis. At the same time, the valves in the veins close, trapping blood in the area and causing an erection. After the excitement ends, the vein valves open, the blood flows out, and the penis returns to its usual state.

Blood flow that’s not normal can cause priapism, an erection that lasts for more than 4 hours, is usually painful, and may happen without sexual arousal.

It can happen to males of all ages, including newborns.

There are two main types:

What Causes Priapism?

Other causes include:

• An injury to the spinal cord or genital area
• Black widow spider bites and scorpion stings
• Carbon monoxide poisoning
• Using street drugs like marijuana and cocaine

It’s rare, but priapism can happen because of cancers that affect the penis and prevent blood from flowing out of the area.

Getting a Diagnosis

If you think you might have priapism, you need to get medical care right away. Tell your doctor:

• How long you’ve had the erection
• How long your erections usually last
• Any drugs, legal or illegal, that you’ve used
• If the problem happened after an injury

Your doctor will review your medical history and do a thorough physical exam to figure out what’s causing your problem. They’ll check your rectum and belly for any signs of cancer. You may also need to see a urologist for more screening tests, including:

• Blood tests
• An imaging test called a color Doppler ultrasound, which shows how blood is flowing in your penis
• An X-ray called an arteriogram that detects a dye your doctor injects into an artery

Treatments

The goal of any treatment for the condition is to make the erection go away and prevent ED. Options include:

If you think you have priapism, don't try to treat it yourself. Instead, get emergency care as soon as possible.

What's the Outlook?

Most people recover completely when they get treatment quickly. But the longer you go without medical care, the greater your risk of lasting problems getting and keeping erections.

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