Contents
Treating Priapism: From Medications to Surgery
Published: Nov 30, 2023
Prompt and appropriate treatment of priapism is crucial to prevent long-term erectile dysfunction. The approach depends on the type and duration of priapism.
Treating Ischemic Priapism
For ischemic priapism lasting less than 4 hours, doctors often start with intracavernosal injection of a sympathomimetic drug like phenylephrine. This helps contract blood vessels and reduce blood flow. For cases lasting longer, aspiration of blood from the penis may be necessary, followed by irrigation and medication.
Surgical Interventions
If medication and aspiration don't work, surgery may be needed. This often involves creating a shunt to redirect blood flow. In severe cases lasting more than 48 hours, doctors might consider immediate penile prosthesis implantation to prevent permanent erectile dysfunction.
Managing Nonischemic Priapism
Nonischemic priapism often resolves on its own and doesn't require immediate treatment. If it persists, doctors might recommend selective arterial embolization to block abnormal blood flow. In rare cases, surgical ligation of the affected artery may be necessary.
Frequently Asked Questions
They work in about 80% of cases if used early.
No, it's usually a last resort.
Yes, especially in those with underlying conditions.
The Bottom Line
Early and appropriate treatment of priapism is key to preserving sexual function and overall well-being.
References
- Montague DK, Jarow J, Broderick GA, et al. American Urological Association guideline on the management of priapism. J Urol 2003; 170:1318.
- Ridyard DG, Phillips EA, Vincent W, Munarriz R. Use of High-Dose Phenylephrine in the Treatment of Ischemic Priapism: Five-Year Experience at a Single Institution. J Sex Med 2016; 13:1704.
- Ralph DJ, Garaffa G, Muneer A, et al. The immediate insertion of a penile prosthesis for acute ischaemic priapism. Eur Urol 2009; 56:1033.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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