The reconstructive urologists here at University of Utah Health Care have researched and written extensively about this problem. Because of this they have developed a great expertise and helped create one of the commonly used procedures to relieve priapism. For a consultation with one of these urological reconstructive specialists, contact our clinic.
What Is Priapism?
Priapism is defined as an erection lasting more than four hours that is not associated with sexual stimulation. It is generally classified into two types:
- Ischemic (no blood flow),
- Non-ischemic (constant blood flow)
The first, which is the majority of cases, is considered an emergency due to the associated pain as well as to structural changes in the penis that may lead to penile scarring and severe erectile problems. Conservative management is rarely effective except in select circumstances. Interventions may include aspiration of the blood in the penis, injection of medicines to relieve the erections, or surgical procedures.
Non-ischemic priapism presents less emergent risks and may be followed conservatively. If intervention is necessary, angiographic embolization is often the best therapeutic option.
The causes of ischemic priapism are often unknown but may be the result of medications, neurologic disease, or blood abnormalities such as sickle cell anemia. Ischemic priapism is an emergency, since, if left alone, it can cause permanent damage to erections.
Treatment usually starts with getting out the old blood in the penis with a needle and injecting a drug that reverses the erection. If this is not successful, various procedures are usually tried until the erection and pain are gone. If the priapism results in permanent erection problems, the patient usually requires a penile prosthesis. This is a very difficult surgery after priapism (because of scarring) and the patient should be very careful about choosing a urologist with experience for the best outcome.
Non-ischemic priapism is usually caused by injury to the perineum, such as a straddle injury. It is not an emergency, since it does no harm to the erections. Most of the time, the erection will go away although it may take a long time (weeks or even months); if the erection does not go away, techniques are available to block the injured blood vessels to restore normal erections.
William O. Brant, MD FACS FECSM, is a board-certified urologist, specializing in sexual dysfunction, disorders of the penis, Men's Health, Peyronie's disease, male urinary incontinence, scrotal and testicular problems, and prosthetic surgery. He attended Dartmouth College (undergraduate) and the University of Washington, Seattle (graduate) and then... Read More
Dr. Hotaling has significant training in both the clinical aspects of male fertility and genetic epidemiology and he is currently the only fellowship trained male infertility/andrology expert in Utah. He completed a 6 year residency in urology at the University of Washington, elected to pursue a year of sub-specialty training in male infertility ... Read More
Richard is a board certified Physician Assistant. His clinical emphases include men’s health and general urology as well as clinic procedures for hypogonadism, erectile dysfunction, incontinence and Peyronie’s Disease. He works closely with the physicians of the Men’s Health Clinic, including pre-operative and postoperative care. He is a member of ... Read More
Dr. Lenherr is a urologist who focuses on treatment of female incontinence and management of bladder dysfunction. She received her medical degree from the University of Chicago and completed a 6-year residency in urology at the Lahey Clinic outside of Boston. She then elected to pursue two years of sub-specialty clinical training in female pelvic m... Read More
Bladder Augmentation, Chronic Urinary Tract Infections, Complications of Spinal Cord Injury, Complications of Urologic Surgery, Female Incontinence, Incontinence, Mesh Erosion, Neurogenic Bladder, Pelvic Dysfunction/Incontinence, Trauma and Reconstructive Urology, Urology, Vesicovaginal Fistula
Dr. Myers completed specialty training with Dr. Jack McAninch at University of California, San Fransisco. His fellowship was in trauma and urologic reconstructive surgery. In his practice, Dr. Myers treats a variety of conditions. These include conditions like urethral strictures, ureteral scarring from previous surgery or congenital development... Read More
Bladder Augmentation, Complications of Spinal Cord Injury, Complications of Urologic Surgery, Female Incontinence, General Urology, Mesh Erosion, Neurogenic Bladder, Pelvic Fractures and Urethral Injury, Radiation Injuries, Trauma and Reconstructive Urology, Ureteral Stricture, Urethral Stricture, Urinary Diversion, Urinary Strictures and Fistula, Urology, Vesicovaginal Fistula
Kelley is a board-certified adult-gerontology acute care nurse practitioner (AG-ACNP). She has been with the University of Utah Department of Urology since 2014. Prior to this, her educational emphasis was adult urology. Clinical emphases include men’s health and male infertility as well as clinic procedures for hypogonadism, erectile dysfunction, ... Read More