Painful, Long-Lasting Erections? Priapism It Is!
Having a prolonged erection was one of the main concerns for Ankit* (name changed) and his partner since their sex life took a turn for the worse ever since his partner came to know that Ankit had trouble maintaining a proper erection during sex. However, Ankit never wished for an extremely painful erection on an average Sunday morning that refused to return to normalcy, even after many hours had passed.
On a hospital bed in the emergency ward, the chief urologist diagnosed him with priapism- the official medical term for a painful and prolonged erection lasting for more than 4 hours, which could lead to severe damage to the penis if not treated properly. Here’s a look at the issue in greater detail.
Normal Erections ... and Priapism.
Any form of affliction or damage that causes pain or dysfunction to the penis can be categorized as penile injury. Since the penis has sensitive skin and soft tissues, it is not uncommon for it to swell, inflame and hurt due to an injury to the scrotum and foreskin. Penetrating and blunt traumas combined make up approximately 90% of all civilian penile injuries with burns and other accidents make up the remaining 10%. Penile injuries can be due to several factors. Most occur in industrial, automobile accidents, or as a result of attempts at self-mutilation.
Penile injuries can be both external and internal. External penile injury involves scratches, bites, knocks or burns while internal injury can be caused by objects inserted into the urethra, or by a tight and blood-restricting object placed around the penis. Other times, painful swelling can be caused due to an allergic reaction in response to using creams or other products. Sexual intercourse can also cause injuries to the penis. For example, during an erection, the penis is engorged with blood and if it is bent suddenly or forcefully in this state, the force can rupture an internal part of the penis, causing a penile fracture. This might happen when the penis slips out of the vagina and is accidentally thrust against the pelvis during sexual intercourse.
The Science Behind Getting An Erection.
One major worry of penis owners is erectile dysfunction- an inability to maintain a
proper erection and with priapism in the picture, another new worry crops up, which is a failure to bring a painful erection down back into ‘latency.’
However, while knowing ‘why’ an erection happens, most individuals do not know much about ‘how’ an erection occurs. When a penis owner gets aroused (due to medication or sexual stimulation), the arteries in both the penis and pelvis relax and expand, bringing more blood to the spongy tissues in the penis. The valves in the veins of the penis constrict and close at the same time the blood enters the tissues, thus trapping the blood in the area and creating an erection.
After the arousal ends (due to orgasm or lack of sexual stimulation), the veins return to their relaxed state, and the blood flows out of the penis, causing the penis to return to its normal state. But in some cases, the veins remain constricted, leading to a rigid, swollen, and painful erection lasting for hours, which is essentially what priapism is all about.
The Deeper Science Behind Priapism- Causes and Types.
There are two main types of priapism- ischemic and nonischemic priapism. Ischemic priapism is more common than its counterpart and it entails the flow of blood out of the erect penis being blocked due to constriction of veins in the penis or a problem with the contraction of the smooth muscles within the erectile tissue of the penis. Stuttering priapism (no, it does not refer to a stuttering penis owner having a painful and prolonged erection) is a form of ischemic priapism which may begin in childhood and is characterized by unwanted, painful, and REPETITIVE prolonged erections, which may worsen over time. On the other hand, nonischemic priapism is an occurrence commonly associated with trauma, and it entails a blockage of blood flow away from the penis due to the problem in the arteries in the penis (as opposed to the veins in ischemic priapism), and this is characterized by a less painful and less rigid erection.
Moving away from the famous (and wrong) perception that a painful, raging erection is brought about by watching extreme porn or masturbating continuously, the medical causes for priapism hint at sickle cell anemia (with research suggesting that about 75% of males having experienced priapism at least once before the age of 20), medications (antidepressants like Desyrel and injections containing medicines for treating ED such as Caverject), physical injuries to the spinal cord or genital area, excessive alcohol and drug consumption and even penile cancer, according to WebMD. However, it is best advised to head to a urologist or sexologist for a formal diagnosis.
Your Favorite Heading For Priapism: Treatment!
Based on a medical professional’s review of the patient’s medical history, treatment is administered accordingly. The basic first steps involve using ice packs to bring down the swelling and pain in the penis, then reducing further blood flow to the penis with the use of an injectable (like phenylephrine) and finally using a surgical shunt (a passage created through surgery in the penis to allow the collected blood within to drain out), which consequently leads to a reduction in the swelling. If the condition is more severe, then surgery is required. For ischemic priapism, alpha-agonists are injected directly into the penis, which narrows down the arteries present in the penis, thus leading to less blood flow into the already too-swollen-with-blood penis. Pills can also be used to induce the same effect (though only at the referral of an experienced medical practitioner). Surgical methods like arterial embolization (blocking the blood vessel causing the body’s blood flow into the penis) and surgical ligation (tying up a ruptured artery) can sometimes be used for nonischemic priapism.
However, as with most medical issues, prevention is better than cure. Going for regular medical check-ups, proper and timely intake of medications for ED, and treatment for sickle-cell anemia can significantly reduce the chances of getting priapism. But the best part about getting treated for priapism is that with the proper medical care, treatment is very effective, and the patients tend to recover quickly.
Ankit’s story came to a fulfilling end; timely emergency medical treatment coupled with rest and medications finally relieved the extreme pain and swelling he had been suffering for hours due to the ‘scary’ and prolonged erection he experienced. While priapism is an uncommon condition, lack of awareness and stigma surrounding medical care and advisory for sexual (or seemingly sexual) issues is widespread, and this leads to most individuals trying to ‘solve’ these issues on their own or through frivolous and unscientific means like going to ‘saints’ who claim to heal such issues in private. Lying in the domain of medicine, priapism also seeks to address significantly larger physiological problems such as one’s history with diseases like cancer or one’s drug usage, which substantially increases the risk of occurrence of this condition in the particular individual. It is important to realize that problems with erections- whether not being able to have one and not being able to ‘stop’ one- are equally valid and worth being brought to the attention of urologists and sexologists, who can help individuals resolve these issues and bring them closer to a more peaceful state of mind (and a better sex life as well).
Cover Image from: Healthline