There have only been a few reported cases of priapism with the use of phosphodiesterase type 5 inhibitors, used to treat erectile dysfunction 3. Priapism has also been associated with methylphenidate treatment, both with dose increases and decreases 4. The Medicines Adverse Reactions Committee recently considered this association and noted the possibility of more than one biological mechanism. This may be demonstrated by reports of priapism associated with both increase in dose and methylphenidate withdrawal.
The MARC also noted that whilst priapism appears to be a very rare reaction, it is likely to be under-reported and can have serious sequelae if treatment is not sought early enough.
The Centre for Adverse Reactions Monitoring CARM has received isolated reports of drug-induced priapism, including four reports with chlorpromazine and three reports with citalopram. It is often unrelated to or continues long beyond sexual activity. It can be a serious condition due to the risk of permanent tissue damage.
Here we explore the treatment options for priapism, as well as some of the more common causes. The symptoms and types of priapism will also be covered. The primary symptom of priapism is a prolonged erection. Other symptoms depend on the type of priapism that is occurring. Causes vary, and all ages can be affected, but priapism most commonly affects males in early childhood, between ages , and in young adulthood, from ages Diagnosing priapism usually starts with a detailed medical history and physical exam.
The doctor will look at the genitals and groin to determine the pattern of rigidity and whether any trauma has occurred. Sometimes, diagnostic testing is ordered to gain more information.
The procedure for this is as follows:. As well as deciding the presence of priapism, these tests determine what may be causing the condition. It is important for someone who has had an erection, for 4 hours or more, to seek immediate emergency care. The blood trapped in the penis does not have oxygen, which means that the penile tissue is deprived of oxygen and can become damaged or even destroyed.
Without prompt treatment, permanent nerve damage and erectile dysfunction can occur. Tissue damage can begin hours after onset, so it is important to avoid delay in getting emergency help. Any damage to the sensitive penile tissue is permanent and cannot be reversed. Treatment of priapism depends on the type and the cause. In some cases, ice packs to the penis and perineum the area between the base of the penis and the anus , or vigorous exercise such as climbing stairs, may help end the erection.
However, it is still important to see a doctor for treatment to avoid permanent damage to your penis. For immediate relief and to restore normal blood flow to prevent permanent damage, the doctor may use a needle under local anaesthetic to drain the trapped blood from your penis.
They may also inject a vasoconstrictor agent a medicine used to narrow blood vessels. If you have high blood flow priapism the initial treatment is to wait and see. Priapism tends to resolve of its own accord in about two-thirds of men with this condition. If your priapism does not resolve, you may need surgery to block off the offending blood vessels to reduce the blood flow into your penis. Al-Qudah et al for Medscape.
Huang YC et al. Evaluation and management of priapism: update. Nat Rev Urol ; 6: 62— Levey HR et al. Management of priapism: an update for clinicians. Ther Adv Urol ; 6: — Guideline on the management of priapism, NHS Choices. Skip to content. Types of priapism There are 3 types of priapism, which are caused by different mechanisms. Low blood flow priapism Also known as ischaemic priapism, this is easily the most common type of priapism.
Author: myDr. Pelvic Inflammatory Disease — Dr. Norman Swan Sexual Health November 1, ,. Naturally boost your energy without supplements and chemicals Healthy Living November 25, ,.
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