Priapism

Priapism is an uncommon condition that causes a prolonged and often painful erection, which occurs without sexual stimulation. In a third of the cases, the cause is unknown. The remaining cases are caused by an associated condition, including sickle cell disease, pelvic tumors, pelvic infections, leukemia, genital trauma or spinal cord trauma, and medications or recreational drugs.

Priapism is classified into two types – ischemic (no-flow) or non-ischemic (high-flow).

• Ischemic priapism. This is the most common form of priapism and usually occurs with several hours or days of a painful erection. It is caused by an obstruction in the penis' venous drainage, which results in a buildup of poorly oxygenated blood in the corpora cavernosa, the tissue that forms the bulk of the erectile body of the penis.
  
  Ischemic priapism is considered a medical emergency and requires immediate treatment. If left untreated, the condition can significantly damage erectile function, by causing extensive scar tissue build-up and impotence.
• Non-ischemic priapism. This type of priapism is not as common or painful. It is usually caused by an injury to the penis or perineum, the area between the scrotum and anus. The injury causes the artery within the erectile body to rupture, and thus pump large amount of blood to the penis continuously.

Our approach to priapism

UCSF is a national leader in treating urological disorders, including male sexual dysfunction, urinary incontinence, pelvic pain, urinary stone disease, male infertility and prostate disease. We offer the latest treatment techniques, and our team is committed to providing innovative, highly skilled care with compassion.

Treatment for priapism aims to eliminate the erection and pain as well as to preserve normal erectile function. Some cases resolve on their own. Cold showers, ice packs, exercise and pain medications can relieve symptoms.

If these treatments are insufficient, we may need to use other techniques to normalize blood circulation in the penis. These might include injecting drugs to open the veins or placing a shunt to set up a new path for blood flow. When a ruptured artery causes priapism, we employ techniques that cut off the blood flow.