Priapism or prolonged penile erection occurs automatically during REM (Rapid Eye Movement) sleep, from a state of spontaneous sexual arousal or through various stimuli originating from the sense organs, the brain processes and sends the message to the corpora cavernosa to fill with blood and determine the rigidity of the penis.

At the same time, the spongy body of the penis (glans and urethra), dilate by a greater intake of blood flow.

Ceased after sexual stimulation or orgasm, the blood slowly circles in the corpora cavernosa bodies and escapes, emptying around the penis to the flaccid state. Penile erection can last varied from minutes to an hour or two, on average, sufficient for sexual satisfaction.

Priapism is a prolonged penis erection (the corpora cavernosa, but not the spongy part) after the sexual desire is gratified, yet does not get better after orgasm. Priapism or prolonged penile erection can be painful. The name Priapism was used in honor of the Greek god of fertility Priapus.

It is a pathological condition where the penis remains erect for many hours or days. It does not obtain its natural and consequent flaccidity and therefore constitutes an emergency situation where measures to promote detumescence (to become flaccid) should be taken immediately, otherwise the development of serious future consequences for the function of penile erections can occur.

The most common clinical picture of priapism or prolonged penile erection is when the patient is anxious, worried about a penile erection that has lasted for hours or even days unyielding, producing pain in the penis, which appears fully erect, except that the glans that are flabby, while the body of the penis is swollen (bloated) with a temperature that is slightly below expectations.

Priapism or prolonged penile erection has many causes. Some are known, others are not so well known. Among the known causes are: traumatic injuries of the spinal cord, penis, perineum or pelvis, blood diseases like sickle cell anemia and leukemia, the use of drugs such as some antihypertensives, psychotropic drugs and drugs used in penile self injection for the treatment of impotence, and intercourse (penile erectile dysfunction).

When you can not determine the cause, priapism or prolonged penile erection is classified as idiopathic.

The diagnosis of priapism or prolonged penile erection is based primarily on the patient´s condition. You will rarely require additional tests for the diagnosis of priapism or prolonged penile erection. These will be necessary to attempt to establish the cause.

The most commonly performed tests for priapism or prolonged penile erection include: Blood tests (complete blood count, arterial blood gases); imaging for detection of disorders of the pelvis, urethra, prostate and spine (radiographs, CT scans, ultrasounds etc).

The treatment of priapism or prolonged penile erection has two basic aspects:

- To provide immediate detumescence of the corpora cavernosa;

- To fix the underlying cause responsible for the priapism or prolonged penile erection, if possible.

To this end, it employs a series of measures:

- Rest and sedation of the patient;

- Hydration intravenously;

- Suspension or replacement of possible drugs responsible for the disease;

- Blood Transfusions;

- Puncture of the body or penis with needles, to promote aspiration and washing the thick blood stuck in the corpora cavernosa; introduction (by the puncture) of drugs to stimulate the sagging of the corpora cavernosa;

- Surgery, when previous attempts have failed. Surgical procedures aimed at creating an artificial communication between the corpora cavernosa and spongiosum, to divert the blood of those and promote penile flaccidity.

Priapism or prolonged penile erection, mainly caused by sickle cell anemia as well as being idiopathic, tends to re-occcur, requiring patients and doctors to make careful surveillance.

In some cases, especially those in which the erection lasts more than twelve hours, metabolic changes on the delicate tissue of the corpora cavernosa may have as a consequence, penile erectile dysfunction (impotence).

To prevent this from occurring, patients with Priapism or prolonged penile erection must be met by the urologist as soon as possible to avoid disastrous consequences for the ED and quality of life.

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