O priapism it is characterized by a prolonged and persistent erection that, in some cases, lasts longer than eight hours. Unlike erections resulting from sexual stimulation, it often presents with ache. Priapism can occur soon after intercourse, in which the penis is erect for more than four hours, or without any stimulation.
Priapism causes erection of the corpora cavernosa, however, this erection is not seen in the glans and corpus spongiosum. We can classify this disease into two main types: ischemic and non-ischemic.
O ischemic, also called low flow or veno-occlusive, occurs when there is a decrease in venous return, causing tissue ischemia. In these cases, the erection is usually painful. It is essential to see a doctor as soon as you notice the problem, as there is a great risk of impotence if treatment is not started immediately.
in priapism non-ischemic, also known as high flow or arterial, there is an increase in arterial flow, and this type is usually related to perineal or penile trauma. Unlike the ischemic form, erections are painless and there is less risk of sequelae.
Some diseases may be related to priapism, including sickle cell anemia, leukemia, thalassemia and some neurological problems such as spinal cord injuries. Furthermore, the disease can be related to the use of medication, alcohol and drugs.
As soon as symptoms appear, the patient must seek the emergency service so that the appropriate procedures are carried out as soon as possible. To carry out the diagnosis, some exams must be carried out, such as the physical, in addition to the analysis of the patient's clinical It is important to perform a gasometry of the corpora cavernosa, which will provide information about the blood pH and the pressures of oxygen and carbon dioxide. In addition, a color Doppler ultrasound can also be performed. It is extremely important that the physician obtains a quick diagnosis, as the treatment has distinctions according to the type of priapism.
In cases of ischemic priapism (the most frequent type), it is important to empty the corpora cavernosa through puncture. If the puncture does not solve the problem, some intracavernous medications can be used. When no treatment is effective, surgery is chosen, in which communication areas are made between the corpora cavernosa and the spongy. Sometimes, when no procedure is satisfactory, a penile prosthesis can be chosen.
In the case of non-ischemic priapism, no treatment needs to be carried out immediately. It is common for the problem to resolve itself spontaneously.
It is extremely important that all men seek a doctor in case of priapism, especially because of the risk of erectile dysfunction.
By Ma. Vanessa dos Santos
