Priapism
Priapism is a medical condition characterized by a persistent, often painful, erection lasting more than four hours without sexual stimulation. It occurs when blood remains in your penis and can’t drain. This condition needs immediate treatment. Without treatment, it can cause permanent damage.
Types & Symptoms –
It is of two main types: ischemic (low-flow) and non-ischemic (high-flow).
▪︎ Symptoms of Ischemic Priapism (Low-Flow) includes –
– Prolonged and painful erection.
– Stiffening of the penis with reduced or absent detumescence.
▪︎ Causes –
– Blood trapped in the erectile tissues due to impaired venous outflow.
– Commonly associated with sickle cell disease, leukemia, and certain medications.
▪︎ Symptoms of Non-Ischemic Priapism (High-Flow) includes –
– Persistent erection without severe pain.
– Often caused by a ruptured artery leading to increased blood flow.
▪︎ Causes –
– Trauma to the genital area or pelvis.
– Arteriovenous malformations contributing to unregulated blood flow.
Risk Factors –
▪︎ Ischemic Priapism:
– Sickle cell disease and other blood disorders.
– Certain medications (e.g., antipsychotics).
– Trauma or injury to the genital area.
▪︎ Non-Ischemic Priapism:
– Pelvic trauma or surgery.
– Blood clotting disorders.
Complications –
▪︎ Ischemic Priapism:
Erectile tissue damage leading to erectile dysfunction.
Recurrent episodes may worsen long-term outcomes.
▪︎ Non-Ischemic Priapism:
Usually less severe complications compared to ischemic priapism.
Erectile function may be preserved in many cases.
Diagnosis –
• Medical History:
Identifying underlying conditions or medications.
• Physical Examination:
Assessment of the penis, scrotum, and surrounding areas.
• Blood Tests:
Checking for blood disorders, clotting factors, or other systemic issues.
• Imaging Studies:
Doppler ultrasound to differentiate between low-flow and high-flow priapism.
Treatment –
▪︎ Ischemic Priapism:
• Aspiration and Irrigation:
Removing stagnant blood and replacing it with saline.
• Medications:
Sympathomimetic agents (e.g., phenylephrine) to constrict blood vessels.
• Surgery:
Shunting procedures to redirect blood flow.
▪︎ Non-Ischemic Priapism:
• Observation may be sufficient in some cases.
• Surgical intervention if conservative measures fail.
Follow-Up and Management –
• Regular monitoring for recurrence.
• Addressing underlying causes to prevent future episodes.
• Psychological support for patients dealing with erectile dysfunction.
In conclusion, it is a rare but serious condition that requires prompt medical attention. Understanding the type, identifying underlying causes, and choosing appropriate interventions are crucial for successful management. Regular follow-up and comprehensive care contribute to better long-term outcomes and improved quality of life for individuals affected by such condition.
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