Do You Suffer from Priapism?

It's a condition that occurs in men that's so unusual—and so embarrassing—that chances are you may not have heard of it. But priapism is a painfully real disorder, and one that can be uncomfortable to have treated. Fortunately, there is a way to remedy it.

Priapism is a condition in which a man's penis has a prolonged erection that lasts for more than four hours. It's an unwanted erection not caused by arousal or by sexual stimulation, and it tends to occur most often in boys ages 5 to 19, and in men ages 20 to 50.

Most commonly associated with sickle cell anemia, it occurs much more often in those who have the disease. But priapism also is seen occasionally in men who inject penile medications in order to help with erection difficulties, explains Franklin Lowe, MD, of St. Lukes'-Roosevelt Hospital in New York City.

"In the general population, it's not common," says Maria Ordonez, MD, a urological surgeon at NewYork-Presbyterian Hospital/Columbia Medical Center in New York City. "Occasionally men who use cocaine and those who are on psychiatric medications may get priapism."

Taking herbal medications also has been linked to priapism, she says. "These products are off-label and can be a risk factor," she says."  Since some potentially harmful substances could still be showing up in unregulated medicinal herbal products sold over the Internet, it's recommended that these products be avoided, Ordonez says.

The treatment for priapism varies, but typically the blood must be aspirated out of the penis, Lowe explains. "Sometimes medications must be injected into the penis to decrease the erection, and possibly the man must have surgery," he says.

Typically the treatment focuses on getting rid of the blood that is not leaving the penis, Ordonez explains. "This involves putting a needle into the penis to aspirate out the old blood," she says.

It's important to treat priapism quickly to prevent tissue damage, too. If treatment is delayed, tissue could be damaged, and in the future, the man may suffer from erectile dysfunction, in which he's unable to get or to maintain an erection.

Still, men tend to avoid seeking treatment right away because it's an embarrassing condition to go to the doctor with. "If a man has developed priapism because of a penile medication, he may not go to the doctor right away because he wants to keep using the medication," Lowe says. "But then they have enough pain that they come in."

While some sickle cell patients have had the unpleasant condition develop more than once, priapism is really quite rare, Ordonez says.

"It is not something that would be on the top of my list for worries for men," she says.