Priapism (Painful Erection), A Simple Guide To The Condition, Treatment And Related Conditions

By Kenneth Kee

Priapism is a prolonged erection of the penis which is usually painful and lasts more than 4 hours.
It is not necessarily related with sexual desire or excitement and does not subside after ejaculation
Priapism may occur by itself or caused by medical treatment (iatrogenic) and can occur in all age groups including newborns.
It usually affects men between the ages of 5 to 10 years and 20 to 50 years.
There are two types of priapism:
1. The low flow priapism is the result of blood being stuck in the erection chambers.
Low flow priapism usually occurs without a known cause in men who are otherwise healthy but also affects men with sickle cell disease, leukemia (cancer of the blood) or malaria.
2. High-flow priapism is less common than low-flow and usually not painful.
It occurs from a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus) which prevents blood in the penis from circulating normally.
Medically the condition is associated with high blood flow when there is little risk of tissue damage or low blood flow when the risk of damage is higher.
Some 35 per cent of cases are idiopathic (unknown cause) and 21 per cent are associated with drug therapy or alcohol abuse.
Injury accounts for 21 per cent and blood disorders 8 per cent.
A painful erection that lasts for longer than four hours requires treatment in hospital.
Many cases resolve spontaneously after repeated ejaculation, physical activity or a brisk walk.
Oral terbutaline (e.g. Bricanyl) or salbutamol (e.g. Ventolin) may help if given early.
Blood (50ml) can be removed by a doctor inserting a large bore (19G+) needle into the penis often in conjunction with heparin and saline to reduce clotting.
In resistant cases, a reversing agent, metaraminol (1 per cent solution), may be injected into the penis.
Rarely surgery is required to avoid permanent damage to the muscle of the penis.
Surgery may be suggested if the condition does not respond to aspiration or injections.
There are several operation procedures available depending on the type of priapism you have.
If you have low flow priapism, shunt surgery may be recommended.
A small device called a shunt is implanted into the penis to re-route the blood supply out of the penis.
TABLE OF CONTENT
Introduction
Chapter 1 Priapism
Chapter 2 More about Priapism
Chapter 3 Treatment of Priapism
Chapter 4 Erectile Dysfunction
Chapter 5 Sex and Priapism
Chapter 6 Sickle Cell Anemia
Chapter 7 Types of Penises
Epilogue

Priapism is a persistent erection which causes the penis pain.
It is not related to sexual desire or sexual excitement
Priapism may be spontaneous or caused by medical treatment
Any penis erection over 4 hours will require immediate management

Causes for ischemic priapism are sickle cell anemia and blood conditions
Patients with ischemic priapism typically have pain and rigid erections
Non-ischemic priapism is often due to the rupture of artery in the penis from injury
Other causes are perineum surgery and illegal drug therapy

Full blood count and hemoglobin analysis will exclude sickle cell anemia
In high flow priapism ultrasonography can help identify and locate fistulas
Aspiration of old blood from the pooled blood in the penis is a simple intervention
Intracavernous injection of alpha agonists will help in the arterial constriction

-An original poem by Kenneth Kee

• Language: English
• Publisher: Kenneth Kee
• Release date: Jan 24, 2017
• ISBN: 9781370780150

Kenneth Kee

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 70. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com This autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 1000 eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical disorders. He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Buona Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. The entire PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"

Book preview

Priapism

(Painful Erection),

A

Simple

Guide

To

The Condition,

Treatment

And

Related Conditions

by

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2014 Smashwords Edition

Published By Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

to my wife Dorothy

and my children

Carolyn, Grace

and Kelvin

This book describes the Priapism, Treatment and Related Conditions or in vernacular terms

(What You Need to do in Priapism)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

Ode to Priapism

Priapism is a persistent erection which causes the penis pain.

It is not related to sexual desire or sexual excitement

Priapism may be spontaneous or caused by medical treatment

Any penis erection over 4 hours will require immediate management

Causes for ischemic priapism are sickle cell anemia and blood conditions

Patients with ischemic priapism typically have pain and rigid erections

Non-ischemic priapism is often due to the rupture of artery in the penis from injury

Other causes are perineum surgery and illegal drug therapy

Full blood count and hemoglobin analysis will exclude sickle cell anemia

In high flow priapism ultrasonography can help identify and locate fistulas

Aspiration of old blood from the pooled blood in the penis is a simple intervention

Intracavernous injection of alpha agonists will help in the arterial constriction

-An original poem by Kenneth Kee

Interesting Tips about the Priapism

A Healthy Lifestyle

1. Take a well Balanced Diet

2. The presence of a painful erection for longer than four hours requires treatment in hospital.

Many cases resolve spontaneously after repeated ejaculation, physical activity or a brisk walk.

Oral terbutaline (e.g. Bricanyl) or salbutamol (e.g. Ventolin) may help if given early.

Blood (50ml) can be removed by a doctor inserting a large bore (19G+) needle into the penis often in conjunction with heparin and saline to reduce clotting.

In resistant cases, a reversing agent, metaraminol (1% solution), may be injected into the penis.

In very rare cases, surgery is required to avoid permanent damage to the muscle of the penis.

Surgery may be recommended if the condition does not respond to aspiration or injections.

There are several surgical procedures available, depending on the type of priapism you have.

If you have low flow priapism, shunt surgery may be recommended.

This involves implanting a small device called a shunt into the penis to re-route the blood supply out of the penis.

If you have high blood flow priapism, a surgical technique called embolization may be used.

It stops the flow of blood into the penis by inserting a small device to block the damaged artery.

Surgical ligation is another method used to treat non-ischemic priapism.

Here the surgeon ties off the damaged artery to restore normal blood flow to the penis.

Luckily, with the development of oral drugs, cases of priapism due to impotence treatments are becoming increasingly rare.

3. Keep bones and body strong

Bone marrow produces our blood

Eat foods rich in calcium like yogurt, cheese, milk, and dark green vegetables.

Eat foods rich in Vitamin D, like eggs, fatty fish, cereal, and fortified milk.

Eat food rich in Vitamins B and C such as green vegetables and fruits

Zinc and other minerals are important to the body

4. Get enough rest and Sleep

Avoid stress and tension

5. Exercise and stay active.

It is best to do weight-bearing exercise such as walking, jogging, stair climbing, dancing, or lifting weights for 2½ hours a week.

One way to do this is to be active 30 minutes a day at least 5 days a week.

Begin slowly especially if a person has not been active.

6. Do not drink more than 2 alcohol drinks a day for a man or 1 alcohol drink a day for a woman.

Alcohol use also increases the chance of falling and breaking a bone.

Alcohol can affect the neurons and brain cells.

7. Stop or do not begin smoking.

It also interferes with blood supply and healing.

Cigarettes contain more than forty types of hazardous and possibly cancer causing chemicals which can harm the smokers and those around them.

Chapter 1

Priapism

What is priapism?

Priapism is a prolonged erection of the penis which is usually painful.

It is not necessarily related with sexual desire or excitement and does not subside after ejaculation (when semen is released from the penis).

Much debate has taken place as to the meaning of 'persistent erection'.

But the present view is that the erection needs to be present for four hours.

In practice the usual advice is to seek medical help for a painful erection persisting for more than four hours.

What causes priapism?

A normal erection results from relaxation of the muscles within the penis and an increase in arterial blood flow to the penis.

The resulting swelling of the muscles compresses the penile veins thus trapping blood within the penis.

After ejaculation the related adrenaline surge constricts the arteries and relaxes the pressure on the veins which leads to loss of erection (detumescence).

Priapism may occur by itself or caused by medical treatment (iatrogenic) and can occur in all age groups including newborns.

It usually affects men between the ages of 5 to 10 years and 20 to 50 years.