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    Erectile Dysfunction and Priapism

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    Erections can’t happen without proper blood flow. Normally when a man gets aroused, the arteries in his 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.

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

    There are two main types:

    • Low-flow or ischemic priapism: This type happens when blood gets trapped in the erection chambers. Most of the time, there’s no clear cause, but it may affect men with sickle-cell disease, leukemia (cancer of the blood), or malaria. If you don’t get treatment right away, it can lead to scarring and permanent erectile dysfunction (ED).
    • High-flow or non-ischemic priapism: This type is more rare than low-flow and is usually less painful. It often happens when an injury to the penis or the area between the scrotum and anus, called the perineum, ruptures an artery, which prevents blood in the penis from moving normally.

    What Causes Priapism?

    • Sickle cell anemia: Scientists think about 42% of men with sickle cell disease will get priapism at some point.

    Other causes include:

    • An injury to the spinal cord or genital area

    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. He’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
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