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Erectile Dysfunction and Priapism

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A normal erection occurs in response to physical and/or psychological excitement.  Arteries in the pelvis and penis relax and expand, increasing blood flow to spongy tissues in the penis, while the valves in the veins close, trapping blood in the corpora ( the spongy tissue) and causing an erection. After stimulation ends, the valves in the veins open, the blood flows out, and the penis returns to its nonrigid (flaccid) state.

Priapism is a persistent, usually painful, erection that lasts for more than four hours and may occur without sexual stimulation. 

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It can occur in all age groups, including newborns.

There are two categories of priapism: low-flow and high-flow.

  • Low-flow or ischemic priapism: This type of priapism is the result of blood being trapped in the erection chambers. It often occurs without a known cause, but may affect men with sickle-cell disease, leukemia (cancer of the blood), or malaria. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.
  • High-flow or non-ischemic priapism: High-flow priapism is more rare than low-flow and usually less painful. It is usually the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally.

What Causes Priapism?

  • Sickle cell anemia: Some cases of priapism are the result of sickle cell disease. It has been estimated that approximately 42% of adults with sickle cell disease will eventually develop priapism.
  • Medications: A common cause of priapism is the use and/or misuse of medications. Drugs that may cause priapism include Desyrel, used to treat depression, or Thorazine, used to treat certain mental illnesses. For people who have erectile dysfunction, oral or injection drugs used to treat the condition may also cause priapism.

Other causes of priapism include:

In rare cases, priapism may be related to cancers that can affect the penis and prevent the outflow of blood.

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