PRIAPISM
Priapism is a condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. Priapism is considered a medical emergency which should receive proper treatment by a qualified medical practitioner.
The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.It can occur in all age groups, including newborns.
There are two types of priapism: low-flow and high-flow; 80% to 90% of clinically presented priapisms are low flow disorders. Low-flow involves the blood not adequately returning to the body from the organ. High-flow involves a short-circuit of the vascular system partway along the organ. Treatment is different for each type. Early treatment can be beneficial for a functional recovery.
Priapus is a fertility god (greek) represented with a disproportionately large and permanent erection.
In the normal erection process, blood flows into the penis and, usually following an orgasm, drains out of the penis without discomfort. When priapism occurs the blood is unable to drain as it would -normally occur.. Because there is little room in the penis for blood to circulate, it becomes stagnant and begins to lose oxygen. Without oxygen, red blood cells become stiff, making proper penis drainage even more problematic.
The causative mechanisms are poorly understood but involve complex neurological and vascular factors. Any bodily ailment that causes blood to thicken or causes red blood cells to lose their flexibility and mobility can lead to priapism. Priapism may be associated with blood disorders, like sickle cell disease, malaria and other conditions such as leukemia, thalassemia, and neurological diseases such as spinal cord lesions lesions and spinal cord trauma. It has been estimated that approximately 42% of adults with sickle-cell disease will eventually develop priapism.
Priapism can also be caused by reactions to drugs like desyrel, used to treat depression, or thorazine, used to treat certain mental illnesses ,marijuana and cocaine.The most common medications that cause priapism are intra-cavernous injections for penile doppler,or treatment of erectile dysfunction, like papaverine etc.
Potential complications include ischemia, clotting of the blood retained in the penis (thrombosis), and damage to the blood vessels of the penis which may result in an impaired erectile function or impotence. In serious cases, the ischemia may result in gangrene, which could necessitate penectomy
.Medical advice should be sought immediately for cases of erection beyond four hours and one should be honest in giving proper information about situation/drug intake if any, leading to priapism.
Apart from analgesics, locally Ice is applied to the penis and perineum may reduce swelling.
If there is still no relief,the treatment at this stage is to aspirate blood from the corpus cavernosum under sedation with the help of anaesthesiologist.. If this is still insufficient, then intra cavernosal injections of phenylephrine are administered. This should only be performed by a urologist/andrologist/specialist trained in the procedure, with the patient under constant ECG monitoring, as phenylephrine can cause severe hypertension, bradycardia/tachycardia,arrhythmia
.As the complication of shortened, indurated and non-erectile penis is high in prolonged priapism, early penile prosthesis implantation can be performed. Apart from early resumption of sexual activity, early implantation can avoid the formation of dense fibrosis and hence a shortened penis.
A general rule of thumb is to pay close attention to excess swelling or pain in the penis and to seek out care sooner rather than later if you suspect something ABNORMAL.
Priapism is a condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. Priapism is considered a medical emergency which should receive proper treatment by a qualified medical practitioner.
The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.It can occur in all age groups, including newborns.
There are two types of priapism: low-flow and high-flow; 80% to 90% of clinically presented priapisms are low flow disorders. Low-flow involves the blood not adequately returning to the body from the organ. High-flow involves a short-circuit of the vascular system partway along the organ. Treatment is different for each type. Early treatment can be beneficial for a functional recovery.
Priapus is a fertility god (greek) represented with a disproportionately large and permanent erection.
In the normal erection process, blood flows into the penis and, usually following an orgasm, drains out of the penis without discomfort. When priapism occurs the blood is unable to drain as it would -normally occur.. Because there is little room in the penis for blood to circulate, it becomes stagnant and begins to lose oxygen. Without oxygen, red blood cells become stiff, making proper penis drainage even more problematic.
The causative mechanisms are poorly understood but involve complex neurological and vascular factors. Any bodily ailment that causes blood to thicken or causes red blood cells to lose their flexibility and mobility can lead to priapism. Priapism may be associated with blood disorders, like sickle cell disease, malaria and other conditions such as leukemia, thalassemia, and neurological diseases such as spinal cord lesions lesions and spinal cord trauma. It has been estimated that approximately 42% of adults with sickle-cell disease will eventually develop priapism.
Priapism can also be caused by reactions to drugs like desyrel, used to treat depression, or thorazine, used to treat certain mental illnesses ,marijuana and cocaine.The most common medications that cause priapism are intra-cavernous injections for penile doppler,or treatment of erectile dysfunction, like papaverine etc.
Potential complications include ischemia, clotting of the blood retained in the penis (thrombosis), and damage to the blood vessels of the penis which may result in an impaired erectile function or impotence. In serious cases, the ischemia may result in gangrene, which could necessitate penectomy
.Medical advice should be sought immediately for cases of erection beyond four hours and one should be honest in giving proper information about situation/drug intake if any, leading to priapism.
Apart from analgesics, locally Ice is applied to the penis and perineum may reduce swelling.
If there is still no relief,the treatment at this stage is to aspirate blood from the corpus cavernosum under sedation with the help of anaesthesiologist.. If this is still insufficient, then intra cavernosal injections of phenylephrine are administered. This should only be performed by a urologist/andrologist/specialist trained in the procedure, with the patient under constant ECG monitoring, as phenylephrine can cause severe hypertension, bradycardia/tachycardia,arrhythmia
.As the complication of shortened, indurated and non-erectile penis is high in prolonged priapism, early penile prosthesis implantation can be performed. Apart from early resumption of sexual activity, early implantation can avoid the formation of dense fibrosis and hence a shortened penis.
A general rule of thumb is to pay close attention to excess swelling or pain in the penis and to seek out care sooner rather than later if you suspect something ABNORMAL.
No comments:
Post a Comment