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Erectile Dysfunction and Priapism

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How Is Priapism Diagnosed?

If you experience priapism, it is important that you seek medical care immediately. Tell your doctor:

  • The length of time you have had the erection
  • How long your erections usually last
  • Any medication or drugs, legal or illegal, which you have used; marijuana and cocaine have been linked to priapism.
  • Whether or not priapism followed trauma to that area of the body

Your doctor will review your medical history and perform a thorough physical exam to determine the cause of priapism. This will include checking the rectum and the abdomen for evidence of unusual growths or abnormalities that may indicate the presence of cancer. A urologist may also perform blood tests, a color doppler ultrasound of the penis, and possibly an arteriogram (an X-ray that detects a dye injected into the artery of the penis).


How Is Priapism Treated?

The goal of all priapism treatment is to make the erection go away and preserve future erectile function. Treatment options include:

  • Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling.
  • Ice packs: Ice applied to the penis and perineum may reduce swelling for high-flow priapism.
  • Intracavernous injection: Used for low-flow priapism, drugs known as alpha-agonists are injected into the penis. This causes the veins to narrow, reducing blood flow to the penis and easing swelling to the area. Oral alpha-agonists have also been used for the acute treatment of priapism.
  • Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically created in the penis to allow the blood to drain and allow circulation to return to normal. Shunts carry a high risk of leading to ED.
  • Surgical ligation: Used in cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow. This is also for high-flow priapism.
  • Arterial embolization is sometimes used to treat high-flow priapism.
  • Spinal anesthesia sometimes relieves the priapism.
  • Ice packs: Ice applied to the penis and perineum may reduce swelling for high-flow priapism.

If you suspect that you are experiencing priapism, you should not attempt to treat it yourself. Instead, seek emergency care as soon as possible.

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