Priapism is an involuntary erection not associated with sexual arousal that lasts more than 4–6 hours. An erection of such duration is inevitably accompanied by pain and change in skin color. In patients with this condition erection persists even after ejaculation. Sometimes there is a danger of developing gangrene from blood stasis. Priapism requires immediate medical attention. Despite the experienced discomfort, men often seek medical help too late.
Priapism can develop at any age, but more often in children 5–10 years old and men 20–50 years old. This is a rather rare condition; patients with such a problem make up only 0.2% of all those who see a doctor for sexual dysfunctions.
Viagra: priapism as a rare side effect
Many erectile dysfunction medications cite priapism as one of the rare side effects. Over the past twenty years, medications such as Viagra, Levitra and Cialis have gained immense popularity. In 2007, the FDA reported a total of 93 priapism cases associated with taking these drugs. Does this mean that Viagra and similar medications can cause this dangerous condition? Researchers presume that in most cases ED pills do not cause priapism directly. Although physicians report this potential side effect, priapism may be associated with an underlying disease or another medication. For example, penile injection therapy is much more strongly associated with priapism than ED pills. There might be a rare genetic trait that makes a person prone to priapism with PDE5 inhibitors intake, but the number of cases is too less to draw any conclusions. And although the incidence of priapism is low, Viagra users may be interested how to avoid the smallest risk of getting this condition.
Safety with Viagra treatment
Today ED drugs such as Viagra, Levitra and Cialis are more accessible than ever. Prices for branded drugs are gradually going down, and generic versions are even more affordable. In addition to traditional pharmacies, now it is possible to order generic ED pills online by using a My Canadian drugstore of your choice. Online pharmacies became widely popular for several reasons: they are time-saving, help to choose best price offers, and spare the embarrassment associated with buying ED pills. Some pharmacies are even offering worldwide delivery. Looking at the current trends, it seems that Viagra will soon become an OTC drug in many countries. But might this accessibility pose a threat to public health? Can uncontrolled Viagra administration lead to negative consequences and how can a particular person avoid them?
Before starting any erectile dysfunction treatment, it is necessary that the patient’s health is assessed. In particular, drugs for erectile dysfunction such as Viagra and Levitra should be used with caution in patients with anatomical penis deformities (penile angulation, cavernous fibrosis, Peyronie’s disease, etc.) or conditions that cause priapism. If the patient has no contraindications for taking Viagra and similar drugs, the likelihood of serious complications is extremely low. However, only a professional can accurately assess the state of various systems of the body and conclude whether or not PDE5 inhibitors are safe for the patient. Therefore, it is highly recommended to consult a doctor with the appropriate specialization before starting any treatment.
Moreover, with timely treatment negative consequences of priapism can be avoided. If you are taking ED medications, it is important to understand types and symptoms of priapism in order to seek medical help when needed.
Causes of priapism
The immediate cause of priapism is blood flow violation in the cavernous bodies of the penis. In some cases, there is a significant increase in the arterial blood flow, leading to overflow of the corpora cavernosa. This is called non-ischemic priapism and often happens with penis injuries. In other cases, there is a deterioration in venous outflow with blood stasis and changes in blood properties. This is called ischemic priapism.
Priapism can occur in the following diseases:
- neurological diseases (brain tumors, spinal cord injuries, consequences of traumatic brain injury, multiple sclerosis);
- blood diseases (leukemia, sickle cell anemia);
- diseases of the male genital organs (inflammation, swelling and penile injuries);
- intoxication (taking cocaine or excessive amounts of alcohol, chronic renal failure).
Other factors leading to priapism:
- Spinal cord injury
- Diseases of the nervous system, multiple sclerosis
- Metabolic diseases, diabetes
- Blood clots
- Poisoning with scorpion or black widow poisons
Medications that can cause priapism:
- drugs injected directly into the genitals for impotence treatment;
- antidepressants: Prozac, buporpion, etc.;
- psychotropic drugs: risperidone (Risperdal), olanzapine (Zyprexa);
- anti-anxiety drugs: diazepam (Valium);
- indirect anticoagulants: warfarin, heparin.
- drugs used to treat erectile dysfunction (sildenafil (Viagra), vardenafil (Levitra)).
What happens?
True priapism begins suddenly, usually during sleep. The penis becomes as tense as possible. In this case, urination is usually not disturbed, since only the cavernous bodies of the penis are filled with blood, and the urethra. An erection is accompanied by pain at the root of the penis and in the perineum, arising several hours after the onset, sometimes with penile swelling. Sexual arousal is uncommon for priapism. Sexual intercourse does not bring relief, since it does not end with ejaculation and does not lead to a weakening of erection, but only intensifies the pain.
Intermittent nocturnal priapism manifests itself as short-term painful erections during sleep. At first, erections with awakenings are quite rare (for example, once a week), but they gradually become more frequent, occur several times a night and become more and more painful. Unlike true priapism, erection weakens after waking up, urinating, walking, taking sleeping pills or sedatives.
Diagnostics
In case of a painful erection lasting several hours, see a doctor immediately. Despite the experienced discomfort, men often seek medical help too late. The main reasons are feeling embarrassed and not knowing which doctor to visit. The universal advice in this case is to call an ambulance.
Priapism is diagnosed by an andrologist, urologist or surgeon on examination. You will be scheduled for a comprehensive examination, since priapism can indicate serious underlying diseases.
Treatment
The earlier treatment is started, the more effective it is. At the initial stage of treatment, a penile puncture is performed using a special needle under local anesthesia with pumping out the excess blood and injecting of vascular drugs. Since these drugs can enter other vessels and cause a drop in blood pressure and loss of consciousness, treatment should be carried out only in a hospital setting with constant blood pressure monitoring.
If pharmaceutical treatment of priapism is unsuccessful, urgent surgery is needed. However, non-ischemic priapism often resolves on its own without treatment. Applying cold to the perineum, the base of the penis, can help bring its state back to normal.
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