What causes priapism? More men than ever are going to hospital with painful erections lasting for hours

What causes priapism? – Last year, there were 326 admissions in England, up 16% from a decade ago.

The rise in the condition, known as priapism, is attributed to the misuse of prescription drugs like Viagra as well as illegal drugs like cocaine, according to doctors.

It can also be triggered by illnesses like sickle-cell disease and leukemia, with Covid being linked to some recent cases.

More men are believed to have come forward as a result of TV shows like Channel 4’s Embarrassing Bodies.

Priapism can cause scarring or impotence if not treated promptly with medicine, ice packs, or surgery.

According to NHS Digital data from England’s hospitals, the average age of a patient was 40, though one was in his 90s last year and six were in their 80s the year before.

“This increase is unlikely to be related to increased medication use,” said Dr Shalini Andrews of the British Association for Sexual Health and HIV.

“It’s possible that it’s linked to the worsening of pre-existing conditions or the increased use of recreational drugs.”

What causes priapism? More men than ever are going to hospital with painful erections lasting for hours
What causes priapism? More men than ever are going to hospital with painful erections lasting for hours

What is priapism?

Priapism is a long-lasting, usually painful erection that occurs without sexual stimulation and lasts more than four hours. When the blood in the penis becomes trapped and unable to drain, the condition develops. If not treated promptly, the condition can result in scarring and permanent erectile dysfunction.

Priapism can affect people of all ages, including newborns. However, it mostly affects men in two age groups: between the ages of 5 and 10, and between the ages of 20 and 50.

There are two types of priapism: low-flow and high-flow.

  • Low-flow priapism: This is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but it also affects men with sickle-cell diseaseleukemia (cancer of the blood) or malaria.
  • High-flow priapism: This is rarer and is usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (the area between the scrotum and anus), which prevents blood in the penis from circulating normally.


What causes priapism?

  • Sickle cell anemia: Some adult cases of priapism are the result of sickle-cell disease. Approximately 42% of all adults with sickle-cell will eventually develop priapism.
  • Medications: A common cause of priapism is the use and/or misuse of medications, including drugs such as Desyrel® (used to treat depression or as a sleeping aid) or Thorazine® (used to treat certain mental illnesses). For people who have erectile dysfunction, injection therapy medications to treat the condition may also cause priapism.

Other causes of priapism include:

  • Trauma to the spinal cord or to the genital area.
  • Black widow spider bites.
  • Carbon monoxide poisoning.
  • Drug use, such as marijuana and cocaine.

In rare cases, priapism may be related to cancers that can affect the penis and prevent the outflow of blood.


How is priapism diagnosed?

If you have priapism, it is important to get medical care immediately. Tell your doctor:

  • How long you have had the erection.
  • How long your erection usually lasts.
  • If you have used any medication or drugs, legal or illegal. Be honest with your doctor—drug use is especially of interest, since both marijuana and cocaine have been linked to priapism.
  • Whether or not the priapism happened after trauma to that area of the body.

To help determine the cause of priapism, your doctor will review your medical history and conduct a physical examination.

The doctor will take a blood gas measurement of the blood from the penis after the physical exam is completed. A small needle is inserted into the penis, blood is drawn, and the sample is sent to a lab for analysis. This indicates the type of priapism, the length of time the condition has been present, and the extent of the damage.

How is priapism treated?

All treatments aim to get rid of the erection while also preserving the ability to have erections in the future. The erection can almost always be reduced with medication if it is received within four to six hours. Decongestant medications, which reduce blood flow to the penis, may be very helpful if the erection has lasted less than four hours. Other options for treatment include:

  • Ice packs: Ice applied to the penis and perineum may reduce swelling.
  • Surgical ligation: Used in some cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow.
  • Intracavernous injection: This treatment is used for low-flow priapism. Drugs known as alpha-agonists are injected into the penis. They cause the arteries to narrow, reducing blood flow to the penis and causing the swelling to decrease.
  • Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal.
  • Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling.

If you think that you are experiencing priapism, you should not attempt to treat it yourself. Instead, get emergency help as soon as possible.

What are the types of priapism?

There are several different types of priapism:

  • Ischemic: Also known as low-flow priapism, it occurs when blood is not able to leave the penis after an erection. Most cases of priapism are ischemic.
  • Recurrent: This is a type of ischemic priapism also called recurrent or stuttering priapism. It is uncommon and usually seen in men with sickle cell anemia.
  • Non-ischemic: Also known as high-flow priapism, this type is caused by poorly regulated blood flow in the penis.

What is the outlook for people with priapism?

The majority of people have a very good prognosis as long as they receive prompt treatment. The longer you wait to seek medical help, the more likely you are to develop permanent erectile dysfunction.

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Can Priapism Cause Infertility?

Priapism is a condition marked by a prolonged and painful erection of the penis in the absence of sexual stimulation.

Ejaculation has no effect on it. It occurs as a result of a disrupted blood supply to the penis, which is trapped and not drained out during erection.

This is a painful and unpleasant condition. It could last longer than 4 hours. Males can develop it at any age, but it is most common in their third decade.

It necessitates emergency treatment if it lasts longer than 4 hours. It can cause erectile dysfunction and permanent damage to the penis if not treated promptly.


What causes priapism? More men than ever are going to hospital with painful erections lasting for hours
What causes priapism? More men than ever are going to hospital with painful erections lasting for hours


Priapism is a urologic emergency and should be treated immediately if it remains more than 4 hours. It can cause permanent damage to the penis making the patient infertile.

Due to the insufficient blood supply, the tissues inside the penis are deprived of oxygen. If the erection continues for a longer period, these tissues are damaged or destroyed.

Thus, the tissues of the penis get scarred and fibrosed.

This can cause permanent damage to the penis. It can result in erectile dysfunction and may affect the sexual life of the patient.

One can become permanently infertile because of priapism.

Priapism is a medical condition of the male reproductive system, which is marked by the prolonged and painful erection of the penis.

The erection takes place without sexual stimulation and is not relieved by ejaculation.

The condition develops by itself and is not related to sexual activity. It settles down by itself in two hours. It can last more than four hours.

  • Priapism can develop at any age in males usually in the age between 5-10 years or 20-50 years. It can also develop in newborns.
  • Priapism is caused by disrupted blood flow in the penis. The blood gets trapped in the erection chambers of the penis and is not able to drain out.
  • The penis becomes more painful with the time. Pain is felt most at the tip of the penis. The person feels uncomfortable and unpleasant due to prolonged erection.


Priapism is a male reproductive system condition in which the penis remains erect for an extended period of time without sexual arousal and is not relieved by ejaculation of sperm.

If it lasts longer than 4 hours, it requires immediate medical attention.

It can cause scarring of the penis tissues and long-term erectile dysfunction, resulting in infertility.

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