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Erection SilhouetteIf you've ever paid attention to those commercials for erectile dysfunction drugs then you may have heard a warning that said something like "in the event of an erection lasting more than four hours, please seek immediate medical attention." While such a predicament may sound a bit amusing and strange at first (imagine having a boner that won't go down for hours!), the truth is that this type of condition can be quite serious. Here we'll take a look at what the medical condition known as "priapism" really is and understand why having an erection for such an extended period of time can in fact be very dangerous.

About Priapism

The official name for this particular penile disorder, priapism, is derived from the Greek god Priapus who was depicted in folklore as having an extremely large and permanent erection. In reality, priapism is a potentially harmful and painful medical condition in which the erect penis does not return to its flaccid state within 4 hours. This state of permanent erection, which can occur even without the presence of physical or psychological stimulation, is considered a medical emergency that requires immediate attention.

Why Priapism Is Dangerous

Before you can truly grasp why priapism is so dangerous, it's important to first understand how a healthy and normal erection occurs. Under normal circumstances a man will get an erection when his nervous system triggers a dilation within the arteries that feed into the corpora cavernosa (the internal spongy tissues located on either side of the penis). These tissues become engorged with blood and harden which constricts the veins within the penis. This constriction prevents blood from leaving and the penis becomes rigid, resulting in what is commonly called an "erection." After a man ejaculates the process is usually then reversed - blood flows out of the penis and back into circulation and the penis becomes soft again.

In the case of priapism, something interferes with the normal process of blood flow within the penis. This problem can be generally grouped into one of two types, non-ischemic and ischemic.

Non-Ischemic Priapism
Non-ischemic priapism is usually the result of an injury. If an artery that feeds into the corpora cavernosa is ruptured, a risk exists that the blood might then spill into the erectile tissues. Even though the blood can still flow inwards and outwards, the outward flow is not sufficient enough to shrink the erection. As a result, a man suffering with non-ischemic priapism will generally experience a semi-hard erection that lasts for several hours.

In the case of non-ischemic priapism, the blood circulation is not completely obstructed so it generally doesn't cause pain and often clears itself up without causing any long-term damage. The extent of treatment for this type of priapism usually consists of applying ice to the penis.

Ischemic Priapism
In the case of ischemic priapism, blood flows into the penis but does not flow back out. The resulting loss in blood circulation deprives the corpora cavernosa of oxygen and causes a painful, rigid erection. This loss of oxygen can damage erectile tissues, cause the formation of scar tissue, cause blood clots to form within the penis and even lead to permanent erectile dysfunction if not treated. In the most severe cases, priapism can even lead to gangrene which might then require penis amputation.

The Causes of Priapism

Although priapism can sometimes occur without an obvious cause, most instances do have a clear medical explanation. As previously mentioned, some drugs used in the treatment of erectile dysfunction disorders can lead to priapism. This is especially true if more of the drug is used than is recommended. Other medications used for psychiatric treatment, such as anti-depressants and anti-psychotics, can also lead to priapism.

There are also medical conditions that can cause priapism, in particular those that directly affect the blood such as sickle-cell anemia and leukemia. Any bodily ailment that causes blood thickening or causes red blood cells to stagnate can lead to painful and prolonged erections. Spinal cord injuries are also commonly associated with priapism.

Treatment for Priapism

If not treated in a timely manner (usually a period of within four to six hours), priapism can scar the penis and lead to impotence. Some men are able to treat priapism through medications which constrict blood vessels to decrease the amount of blood in the penis. Another common treatment is called aspiration which involves having the penis drained of excess blood. Both of these treatment options help relieve the immediate pain experienced with priapism. For those men suffering from priapism as a result of a ruptured penile artery due to trauma, such as a spinal cord injury or paralyzation, surgery is also an option that allows normal penile functioning to be restored.

The bottom line is that if you're a man who is experiencing an erection that lasts for four or more hours and it isn't going away, seek medical attention right away! Priapism is a medical emergency that needs to be treated as soon as possible by a qualified physician. Early treatment can spell the difference between a full recovery and long-term permanent damage.

Posted by PRS
Monday, October 11th, 2010

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