What is Priapism?

Priapism is a painful erection lasting for more than six hours without sexual stimulation or desire. Priapism is caused by the trapping of blood in the penis when swelled muscles compress the penile veins and is unable to drain. This problem may occur to a male of any age group including even the newborns. It affects males between five to ten years and twenty to fifty years.

Mainly, Priapism can be categorized into two sections.

What are the causes of Priapism?

Sickle Cell Anemia : Almost 42 % cases of sickle cell anemia develop Priapism in adults.

Medication : Medications and drug abuse are a common cause of Priapism. Mainly when Viagra or other PDE5 inhibitors are taken concurrently with life style drugs like Ecstasy etc. the result may be Priapism.

Trauma : If spinal cord and genital area experiences trauma, it may result in Priapism.

Spider Bite : Cases of black widow spider bite may also be responsible for Priapism

Carbon mono oxide : Carbon mono oxide poisoning, at times, is responsible for Priapism.

Illicit drug abuse : Illicit drug abusers who use cocaine and marijuana type of substances experience Priapism.

How Priapism can be diagnosed?

When a man suspects Priapism, he should let his doctor know

What are the treatments of Priapism?

A person who suffers Priapism should seek immediate medical help after 4 hours of continuous erection. The doctors treat the condition keeping in mind to preserve the future erectile function of the penis.

Medication : The prolonged erection can be reduced by medications most of the time.

Ice Packs : Ice packs, if applied to penis and the perineum, can reduce the swelling.

Intracavernous injection : It is used for low-flow Priapism. In this treatment, alpha-agonists drugs are injected into the penis to reduce blood flow to the penis.

Surgical Ligation : It is used in the case of a ruptured artery in which the doctor ties off the artery which is responsible for Priapism. As a result the normal blood flow is restored and the penis erection is reduced.

Surgical Shunt : It is used in low-flow Priapism in which a passageway is inserted in the penis to divert the blood flow allowing the blood flow to settle down to normal.

Aspiration : The doctors insert a needle into the penis to drain the extra blood. It is done after anesthetizing the penis. This way, the pressure of blood and swelling are reduced.

IMPORTANT NOTE: It must be remembered that the longer it takes to treat Priapism, the greater are the risk of permanent erectile dysfunction.

Peyronie's Disease

What is Peyronie's Disease?

Peyronie's disease is a very uncommon sexual dysfunction in which the penis is bent during erection. This is caused by a layer of damaged tissues in the penis; the layer is hard, leathery, most of the time develops under the upper or lower side of the penile skin.

When the penis is erect as a result of sexual stimulation, the scar tissues pulls the effected area at a certain angle and the penis becomes curved. However, the plaque in the erectile tissue is non-cancerous or benign.

What are the symptoms of Peyronie's Disease?

One characteristic of this disease is, the symptoms may appear very slowly so you may suddenly experience Peyronie's Disease one day.

The symptoms of this disease are:

What are the causes behind Peyronie's Disease?

The researchers have not been able to find out the real cause behind this problem. However, there are theories which are referred as the causes behind Peyronie's Disease.

Penis Injury : If the penis is hit or bent abnormally while erect or having intercourse, it may tear off the tissue or internal rupture and bleeding of the penis. When this condition of the penis is healed abnormally, a plaque may develop under the skin gradually building a hard layer of damaged tissue which will cause a deformed penis.

Collagen Abnormality : If there is an abnormality in the substance that builds and remodels the connective tissue or collagen, it may also induce Peyronie's disease.

Autoimmune Disorder : When a person's immune system responds abnormally, it may form plaque while helping the penis recover from injuries.

Medications : Medications as beta blockers which are used to treat conditions like hypertension and heart disease can cause Peyronie's disease as a side-effect of the drugs. But these drugs cause Peyronie's disease in rare instances.

How Peyronie's Disease is diagnosed?

Doctors diagnose this disease mainly by;

How Peyronie's Disease is treated?

The course of this disease varies from person to person. Some patients experience improvement in the condition without treatment. That is why, at the initial stage, the doctors take a wait-n-watch approach.

However there are surgical as well as non-surgical ways to treat Peyronie's disease.

Surgical Methods

Plaque excision : The plaque in the penis is removed by surgery and replaced with a patch of skin from the pelvic area.

Nesbit Plication : To cancel the bending effect, tissue from the opposite side of the plaque is removed or pinched.

Plaque incision with saphenous vein graft : It is done by linear grafting of the plaque which helps in straightening the erect penis.

Penile Prosthesis : It is a device that is implanted into the penis to straighten the penis and increase its firmness.

Non-surgical Methods

Intralesional Injection: Injecting drugs like collagenase or calcium channel blockers directly into the plaque. This is a course of three months with multiple injections. However, this treatment has side-effects on healthy tissue of the penis.

Vitamin E : Improvement in the condition has been seen with vitamin E oral intake. However, this finding is open to more research and for proper validation.

Reference: Mayoclinic

More on Sexual Dysfunctions in Men :

• Priapism
• Peyronie's Disease
• Inhibited Sexual Desire
• Male Infertility and Treatment
• FAQs on Other Sexual Dysfunctions in Men