Priapism

WHAT YOU SHOULD KNOW:

Priapism (Inpatient Care) Care Guide

  • Priapism is a condition in which your penis remains erect (rigid) for a long time without sexual stimulation. This happens when there are problems with the flow of blood in and around your penis. With priapism, too much blood may go into your penis, or blood may not be able to flow out. The buildup of blood in your penis causes it to become engorged (very full) and rigid. With high-flow priapism, too much blood enters your penis and drains out very slowly. With low-flow priapism, blood is not able to flow out from your penis. Stuttering priapism occurs when you have painful erections that happen over and over. The erections usually are not as painful as low-flow priapism. They can last for a few minutes to a few hours. The engorgement caused by priapism may put pressure on the tissue in your penis, causing pain and damage.

  • Some blood disorders, such as sickle cell disease or leukemia (cancer of the blood) may increase your risk of having priapism. Other conditions such as spinal cord injury, hemodialysis treatments, or getting nutrition through a tube increase your risk of getting priapism. Certain medicines, such as those used for mental health conditions or erectile dysfunction (trouble having an erection) may cause priapism. If you have been using street drugs, such as cocaine or marijuana, you have a greater risk of having priapism. Injuries to or near your penis may also cause priapism. Treatment can help your penis become soft again and prevent permanent damage to your penis. Receiving treatment quickly may decrease your risk of future problems such as erectile dysfunction (trouble having an erection).

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may have a reaction from medicines that are used to help blood flow out of your penis. Reactions may include headaches, high blood pressure, sweating, swelling, or skin rash. Your heartbeat may become irregular, slow, or fast. Hormone therapy may cause diarrhea (loose, watery bowel movements), hot flashes, swollen breasts, and a decrease in sex drive. Caregivers may be unable to remove the blood in your penis. Even after treatment, your priapism may come back. The aspiration procedure may cause you to get a hematoma (pooling of blood under the skin in your penis), or an infection. The shunt procedure may cause certain problems such as a urethral fistula (abnormal opening in your urethra). The shunt procedure may also cause inflammation of the tissue in your penis.

  • You may need more than one treatment to soften your penis. Even with treatment, you may have an erection that lasts longer than four hours. This may cause permanent damage to the tissue in your penis. You may lose your desire for sex. If you do not get treatment right away, you may have greater tissue damage, which can lead to erectile dysfunction. Speak to your caregiver if you have any questions or concerns about your condition, medicines, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Pain medicine:

Caregivers may give you medicine to take away or decrease your pain.

  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

You may need one or more of the following tests to help caregivers plan your treatment:

  • Blood tests: Caregivers may do blood tests to learn more about your condition and the type of priapism you have. Caregivers may need to take blood from your arm or your penis. They may need more than one sample to see if your condition is getting better.

  • Urine tests: Samples of your urine may be taken to test for medicines that you have taken. These can include medicines prescribed by your caregiver or street drugs.

  • Ultrasound: Sound waves are used to show pictures of your penis on a TV-like screen. This test shows how blood is flowing in your penis and where blood vessels may be blocked.

  • Angiography: This test shows pictures of the blood vessels in your penis. Caregivers may put a dye in your vein to see your blood vessels more clearly in the pictures.

Treatment options:

Treatment depends on which type of priapism you have. If you have a medical condition that is causing priapism, such as sickle cell disease, caregivers will also treat that condition. Your treatment may include any of the following:

  • Low-flow priapism:

    • Aspiration: Caregivers may use needles to remove blood from your penis. They may irrigate (wash out) your penis with fluids to help clear out the blood. Caregivers may also put a medicine into the fluid that helps the blood flow out of your penis so it can get soft again. Caregivers may put a pressure bandage on your penis after this procedure to help your penis stay soft.

    • Surgery: Caregivers may need to create a shunt (passage) for blood flow within your penis. The shunt helps to take away extra blood from your penis. Even after treatment, you may have permanent damage to the tissue in your penis, which can cause erectile dysfunction.

  • High-flow priapism:

    • Observation: With high-flow priapism, the penis may become soft on its own without any treatment. Caregivers may watch you closely for a period of time to see if your priapism gets better without treatment. They may also do any of the following:

      • Ice: Caregivers may put ice or cold packs on your penis for short periods of time. This can help slow down the blood flow to your penis.

      • Walking: Walking may help the blood drain out of your penis and circulate better in your body.

    • Embolization: Embolization is a procedure in which the blood flow within a blood vessel in your penis is blocked off. Caregivers do this by placing a small plug in the blood vessel. This may help to keep the blood flow normal.

    • Surgery: Caregivers may do a procedure called surgical ligation to tie off a part of a blood vessel in your penis.

  • Stuttering priapism:

    • Medicines: Hormone therapy may be used to prevent priapism. If you cannot use hormone therapy, your caregiver may teach you how to give yourself an injection of medicine. This medicine can be used to treat priapism when it happens.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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