What Is The Priapism And What is it Causes ?

Some diseases of the blood, especially sickle cell anemia (sickle cell anemia, the most common problem in black), myeloma, thalassemia and leukemia .

Injuries: whether accidental or surgical

Nervous system disorders: especially spinal cord injury (rarely multiple sclerosis or diabetes ).

Drugs: used to treat impotence (especially those that are administered by injection into the penis).In most cases it is due to a bad adjustment of dose. Among them we can mention:

Other drugs, especially in overdose

Local extension of solid tumors

– Papaverine (use by injection into the corpora cavernosa of the penis)
– Prostaglandin E1 (intracavernosally applies; this medication also is available for use in the urethra, penis tube through which urine is eliminated, in this case the priapism is a rare circumstance).
– Phentolamine (intracavernosally, in the near future will be available orally).
– Sildenafilo (Viagra). Sildenafil (Viagra). Practically this is not known complication associated with its use, unless combined with other medications, for example, prostaglandin injections (intracavernous drug most used).

How is it diagnosed priapism?
It is essential to make a good interview the patient (including history, medications, illness being treated, the presence of associated pain, etc.) To assess whether or venous blood type. To proceed to the extraction of blood from the corpora cavernosa to clarify this point, because depending on whether venous or arterial type, apply different type of treatment.If yet not clarified this situation, you can perform an ultrasound doppler to clear the doubt.

How is priapism?
The presence of a painful erection for more than four hours warrants medical evaluation (urological) emergency.

Treatment varies depending on the type completely concerned priapism.If a problem is venous (low flow priapism), the steps would be:

– Many cases resolve spontaneously doing moderate physical activity (eg, brisk walking). Terbutaline or salbutamol can help if taken in the early stages.
– The physician can remove blood from the penis by inserting a needle, proceeding to the repeated washing with saline cavernosa, sometimes adding coagulation inhibiting substances such as heparin.
– In resistant cases can be injected into the penis an agent causing detumescence, as etilefrine, phenylephrine or methoxamine. In these cases, it is desirable to control the heart rate and blood pressure of the patient, which may rise significantly with the use of these substances.
– In resistant cases, even surgery is required to prevent permanent damage to the erectile tissue of the penis.
– In cases where the priapism is related to the administration of an injection to treat impotence would be an alternative therapy or treatment resume carefully adjusting the dosage.Thanks to the development of effective oral drugs, cases of priapism caused impotence treatments are increasingly rare.
– If it is a priapism pressure (high flux, in most cases produced following trauma), there is no danger of occurrence of erectile tissue injury and the treatment may differ.Although some cases are resolved with medication (eg digoxin for several weeks), in most cases have to occlude (for embolization) damaged artery percutaneous techniques (through the skin of the affected artery is channeled) under control with X-ray .

What are the complications of priapism?
Although not a circumstance happily frequent, priapism (venous) unresolved, can lead to serious injury of the erectile tissue of the penis. If this happens, it can severely affect your ability to have an erection.In this case, the solution to this problem may require placement of an implant or prosthesis within the penis.

Dr Geoff Hackett , a specialist in sexual dysfunction