Page 23 - Urological Health

Priapism is serious; you must go to the ER immediately. Any delays is seeing a doctor about this can
lead to serious complications. At this time, there are no pills to treat priapism.

There are 2 types of priapism:
1. Ischemic priapism occurs when there is a lack of blood flow to the penis.
2. High flow priapism is a result of an injury or trauma and is not an urologic emergency.

Ischemic priapism happens in men of any age, including newborns. It peaks between the
ages of 5 and 10, and 20 and 50 years.

Causes include:
• Sickle cell disease

• Self-injection of erectile dysfunction medication, trazadone and other psychotropic and
recreational drugs (including alcohol and cocaine)
• Certain cancers

In half of all cases, there is no cause to the priapism. Sickle cell disease and leukemia are the most
common causes of priapism in children.
Myth watch: It is extremely rare to get priapism by taking Viagra, Levitra, Cialis or Staxyn,
unless you already have the other causes listed above.

Symptoms: Ischemic priapism is the most common type.

• Priapism is usually painful and does not stop after an orgasm.
• Pain may be delayed until 6 to 8 hours have elapsed.
If untreated, the result is increased lack of blood flow to the penis and lack of oxygen (or acidosis),
with pain and inflammation, with subsequent death of the penis tissue, fibrosis (internal scarring)
and erectile dysfunction.
Tests: There may be different causes of your priapism. Your doctor will perform the following to
determine the exact cause of your priapism:
• Your doctor will take a complete history and physical exam at first. Your doctor will pay
special attention to any medication you may be taking or any recreational drug use, as
well as any sickle cell anemia.
• Your penis will be hard and painful; the head of your penis will be soft (soft glans) in cases
of ischemic priapism.

• A blood test will show your complete blood count, electrolytes and indicate any sickle cell
anemia.

• Your doctor will exam your urine (through a urinalysis) and may examine your urine for
illicit drugs (or a urine toxicology test).

• You may get a needle into the side of your penis to get a blood sample to determine
oxygen levels and confirm ischemic priapism.

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