In this episode of the “Urology Care Podcast”, Dr. Stork discusses priapism with interviewer Casey Callanan of the Urology Care Foundation.
Priapism is an erection that persists for an abnormal length of time. It doesn’t go away following ejaculation and can be painful, and threatening, to the future function of the penis. – Dr. Brian Stork
How common is priapism?
It is not an uncommon condition for urologists to see. I estimate I see a patient with a priapism in the emergency room about once every two months.
When this condition happens, is it an emergency?
Yes, priapism is caused by blood trapped inside the penis. There are different types of priapism. One of the most common types, called an ischemic priapism, is an emergency. We advise patients to go to the emergency room after about four hours of sustained erection. Usually, patients head to the ER on their own because of the discomfort but that’s not always the case.
What other types of priapism are there?
Another type is called non-ischemic priapism, or high-flow priapism, caused by trauma to the pelvis that can cause disruptions in natural blood flow. This type does not generally result in as much discomfort or pain, and the management is a little bit different, but evaluation in the emergency room is still necessary.
What causes priapism?
I sometimes find it helpful to think of the penis as a hydraulic organ, powered by blood. In the natural state, there is always some blood flowing into the penis. With stimulation, nerve impulses causes further relaxation of the smooth muscle around the these blood vessels. As a result, blood rushes into the penis.
When things go right
As blood flows into the penis, the venous spaces within the penis swell and the penis becomes erect. After an orgasm, the venous channels open up, and blood drains out.
When things go wrong
In an ischemic type of priapism, blood flow is going into the penis, but for a number of possible reasons, it is not able to escape. With a non-ischemic, there is blood flow going into the penis continuously, usually as the result of some type of injury to the pelvis.
To learn more about priapism, please listen to the full podcast at the Urology Care Foundation. If you have more questions, please feel free to tweet me @storkbrian. The Urology Care Foundation podcast features top health care experts and urology patients from all walks of life to keep people in touch with crucial facts on urology and healthy living.
