Priapism (patient information)

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Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
Priapism or penis pain is any pain or discomfort in the penis.

What causes Priapism?

 * Bladder stone
 * Bites, either human or insect
 * Cancer of the penis
 * Erection that does not go away (priapism)
 * Genital herpes
 * Infected prosthesis of the penis
 * Infection under the foreskin of uncircumcised men (balanitis)
 * Inflammation of the prostate gland (prostatitis)
 * Injury
 * Peyronie's disease
 * Pimples
 * Reiter syndrome
 * Sickle cell anemia
 * Syphilis
 * Urethritis caused by chlamydia or gonorrhea
 * Recreational drugs. For Eg. Ectasy

Who is at highest risk?
The patient falling in any of the condition mentioned above has the risk for Priapism.

When to seek urgent medical care?
Call your health care provider if you notice any of the following:
 * An erection that does not go away (priapism) -- seek immediate medical attention
 * Pain that lasts for more than 4 hours
 * Pain with other unexplained symptoms

Diagnosis
Your health care provider will do a physical examination and take a medical history, which may include the following questions:


 * When did the pain start?
 * Is it always present?
 * Is it a painful erection (priapism)?
 * Do you feel pain when the penis is not erect?
 * Is the pain in all of the penis or just one part of it?
 * Have you had any open sores?
 * Has there been any injury to the area?
 * Are you at risk for any sexually transmitted disease?
 * Have you been exposed to a sexually transmitted disease?
 * What other symptoms do you have?

The physical exam will probably include a detailed examination of the penis, testicles, scrotum, and groin.

Treatment options
The pain can be treated once its cause has been found. Treatments may include:


 * Infection -- antibiotics, antiviral medications, or other medications (in rare cases, circumcision is advised for long-term (chronic) infection under the foreskin)
 * Priapism -- the erection needs to diminish, a urinary catheter is inserted to relieve urinary retention, and medications or surgery may be given if needed

Home Care

How you treat penis pain at home depends on its cause. Talk to your health care provider about treatment. Ice packs may help ease the pain.

If penis pain is caused by a sexually transmitted disease, it is important for your sexual partner to also be treated.

Where to find medical care for Priapism?
Directions to Hospitals Treating Priapism

Possible complications
An erection that does not go away (priapism) is a medical emergency. Get to the hospital emergency room immediately. Ask your health care provider about getting treatment for the condition causing priapism. Untreated priapism may cause:
 * Erectile dysfunction, the inability of the penis to become or stay erect with sexual arousal
 * Disfiguring of the penis

Prevention
It depends on the underlying cause of the priapism:
 * Treating the cause
 * If a prescription medication was the probable cause, then change medication.
 * Avoiding triggers, such as alcohol or illegal drugs
 * Self-injection of phenylephrine to stop prolonged erections