Check out the following sites for
information on pripism, erectile dysfunction (ED), etc.
You possibly need to get medication, exercise, or contact your doctor or other
healthcare provider.
Causes
The causative mechanisms are poorly
understood but involve complex neurological and vascular factors. Priapism may
be associated with prolonged sexual activity, leukaemia, Fabry's disease,
haematological disorders (such as sickle-cell disease), cerebrospinal disease
(such as syphilis), genital infection, some spinal injuries, or inflammation
(Beers & Berkow, 1999). Priapism can be caused by drugs such as certain
antidepressants, antihypertensives, anticoagulants and corticosteroids. It can
also be a withdrawal symptom of drugs such as heroin. Priapism is often present
in spinal injuries or trauma to the spinal cord.
One of the more significant classes of drugs which may precipitate priapism are
the phosphodiesterase type-5 (PDE5) inhibitors such as sildenafil, tadalafil and
vardenafil. Injected erectile-dysfunction therapies such as alprostadil are also
significant.
Complications
Potential complications include ischaemia, clotting of the blood retained in the penis (thrombosis), and damage to the blood vessels of the penis which may result in an impaired erectile function or impotence. In serious cases the condition may result in gangrene, which may necessitate penis removal.
Treatment
Medical advice should be sought
immediately for cases of priapism.
If the erection has been present for two hours the recommended therapy is
pseudoephedrine 120 mg orally. If this has not subsided by four hours, a further
120 mg of pseudoephedrine is recommended. (Therapeutic Guidelines, 2001)
If the erection has been present for six hours, it is essential to contact a
medical practitioner. The therapy at this stage is to aspirate blood from the
corpus cavernosum under local anaesthetic. If this is still insufficient, then
aspiration is conducted with injections of adrenaline as an adjuvant.
(Therapeutic Guidelines, 2001)
If aspiration fails and tumescence re-occurs, surgical shunts are next
attempted. These attempt to reverse the priapic state by shunting blood from the
rigid corpora cavernosa into the corpus spongiosum (which contains the glans and
the urethra). Distal shunts are the first step, followed by more proximal
shunts.
Should all else fail, complete removal of the penis is necessary.