Published: 18 Jun 2025

ICD9: 607.3      ICD10: N48.30      ICD11: GB06.1

Priapism is a prolonged and painful erection of the penis that is not associated with sexual stimulation or arousal.
It's a serious condition because if left untreated, it can lead to permanent damage to the penis, including erectile dysfunction.

Here's a breakdown of what you should know:

Key characteristics:
Prolonged: The erection lasts for more than four hours.
Painful: It's typically accompanied by significant pain.
Unrelated to arousal: It occurs without any sexual interest or stimulation.

Types: There are two main types of priapism:
Ischemic (low-flow) priapism: This is the more common and serious type. It occurs when blood gets trapped in the erection chambers of the penis. The blood becomes deoxygenated and can damage the tissues. This type is very painful.
Non-ischemic (high-flow) priapism: This is less common and usually less painful. It occurs when an artery in the penis ruptures, often due to an injury. This causes unregulated blood flow into the penis.

Causes: Priapism can be caused by a variety of factors, including:
Blood disorders: Sickle cell anemia and leukemia are common causes, especially in children.
Medications: Certain medications, such as some antidepressants, blood thinners, and drugs used to treat erectile dysfunction, can sometimes cause priapism.
Recreational drug use: Cocaine, marijuana, and alcohol have been linked to priapism.
Trauma: Injury to the penis or perineum (the area between the scrotum and anus) can cause non-ischemic priapism.
Nerve problems: Spinal cord injury or other neurological conditions can sometimes contribute.
In some cases, the cause is unknown (idiopathic).

Symptoms:
A persistent erection that lasts for several hours.
Pain in the penis.
A rigid penile shaft but a soft tip of the penis (glans) in ischemic priapism.

Diagnosis: A doctor will perform a physical examination and ask about the patient's medical history, medications, and any recent injuries. Blood tests (particularly to check for sickle cell anemia) and blood gas analysis from the penis (to determine if it's ischemic or non-ischemic) are also often performed.

Treatment: Treatment depends on the type of priapism.
Ischemic priapism requires immediate treatment to prevent permanent damage. This may involve:
Aspiration: Draining the blood from the penis using a needle and syringe.
Irrigation: Washing out the penis with saline solution.
Medications: Injecting medications into the penis to constrict blood vessels.
Surgery: If other treatments are not effective, surgery may be necessary to create a shunt to improve blood flow.
Non-ischemic priapism may resolve on its own. Observation and ice packs may be sufficient. In some cases, surgery may be needed to repair the damaged artery.

Importance of Seeking Immediate Medical Attention: Priapism is a medical emergency. If you experience a prolonged and painful erection that is not related to sexual stimulation, seek medical attention immediately. The longer priapism goes untreated, the higher the risk of permanent erectile dysfunction.

Disclaimer: This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.