Priapism Surgery: What You Need to Know
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A psychologist with clinical specialization and experience working with sub-clinical and clinical populations. Her areas of interest and expertise include anxiety-related disorders, mood disorders, psychotic disorders, addictions, sexual health and wellness, relationship issues, stress, and geriatric mental health.
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Updated on 03 November, 2023
- Article was updated as part of our commitment to diversity, equity, and inclusion.
"The following blog article may discuss medical treatments and interventions. However, it is important to note that the information provided is for general educational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare professional for personalized medical advice.
Medical treatments are complex and should be tailored to individual circumstances. The information presented in this blog may not be applicable to everyone, as each person's medical condition, history, and needs are unique. Only a qualified healthcare professional can evaluate your specific medical situation, consider relevant factors, and provide appropriate recommendations for diagnosis, treatment options, and monitoring.
It is crucial to note that self-diagnosis, self-medication, or relying solely on the information provided in this blog for treatment decisions can have serious health consequences. "
Priapism and the Surgical Solutions
Priapism is a rare but serious medical condition that affects men, and it can lead to severe complications if not treated promptly. This comprehensive guide will delve into the details of priapism, its causes, and available surgical treatments and answer some frequently asked questions. Our aim is to provide you with accurate and engaging information to empower you in making informed decisions about your health.
Priapism is a prolonged and painful erection that lasts for more than four hours and is not related to sexual arousal. It is considered a medical emergency because, if left untreated, it can lead to permanent erectile dysfunction, tissue damage, and other complications. There are two types of priapism: ischemic (low-flow) and non-ischemic (high-flow). Ischemic priapism is the most common and occurs when blood is trapped in the erection chambers, leading to oxygen deprivation and tissue damage. Non-ischemic priapism is less common and results from excessive blood flow to the penis due to an injury or other underlying condition.
Types Of Priapism
Priapism is a condition in which the penis remains erect for an abnormally long period of time, often more than four hours, without sexual stimulation or arousal. There are two main types of priapism:
Ischaemic priapism: This type is caused by a lack of blood flow to the penis, which can lead to tissue damage and erectile dysfunction if not treated promptly. It is often painful and can be caused by sickle cell anemia, leukemia, or certain medications.
Non ischaemic priapism: This type is usually painless and occurs when blood becomes trapped in the penis, but there is still normal blood flow. Non-ischemic priapism is rare and can be caused by a variety of factors, including trauma to the penis, certain medications, or a congenital abnormality of the blood vessels. It is also known as high flow or arterial priapism.
In addition to the two main types of priapism, there is also a third, less common type called recurrent priapism, which involves repeated episodes of priapism that can be either ischemic or non-ischemic in nature. Recurrent priapism is often associated with sickle cell anemia.
Ischemic priapism is considered a medical emergency, and prompt treatment is necessary to prevent complications such as permanent erectile dysfunction. Treatment typically involves draining blood from the penis using a needle or catheter, and in some cases, medications may be used to help restore normal blood flow.
Non Ischaemic priapism may not require immediate medical attention, but it should still be evaluated by a healthcare professional to determine the underlying cause and appropriate treatment. In some cases, non-ischemic priapism may resolve on its own, but in other cases, treatment may be necessary to prevent complications such as erectile dysfunction.
Causes of Priapism
Priapism can occur due to various causes, including:
Prescription medications, such as those used to treat erectile dysfunction or psychiatric disordersAdvertisements
Illegal drugs, such as cocaine or marijuana
Blood disorders, such as sickle cell disease or leukemia
Spinal cord injuries or nerve damage
Pelvic or genital trauma
Certain cancers, including prostate, bladder, and penile cancers
Indications for Priapism Surgery
The erection has persisted for more than four hours
Non-surgical treatments, such as ice packs, medications, or aspiration, have been unsuccessful
The patient has had multiple priapism episodes
The patient is at high risk for complications, such as tissue damage or erectile dysfunction
Shunt procedures involve creating a passage for blood to flow out of the penis, relieving the trapped blood and reducing the erection. There are various types of shunt procedures, including:
Distal T-shunt procedure (Winter procedure): The surgeon creates a small incision in the glans (head) of the penis to drain trapped blood.
Proximal shunt (Quackles procedure): The surgeon creates a connection between the corpora cavernosa (erectile tissue) and corpus spongiosum (urethral tissue) to improve blood flow.
Corporoglanular shunt (Ebbehoj procedure): The surgeon creates a connection between the corpora cavernosa and the glans to facilitate blood drainage.
Penile Prosthesis Implantation
In cases where priapism has led to permanent erectile dysfunction or tissue damage, a penile prosthesis may be implanted to restore sexual function. There are two types of penile prostheses:
Inflatable penile prosthesis: This type consists of inflatable cylinders that are implanted within the corpora cavernosa, a fluid-filled reservoir placed in the abdomen, and a pump placed in the scrotum. The patient can inflate the cylinders to achieve an erection and deflate them for flaccidity.
Semi-rigid penile prosthesis: This type consists of semi-rigid rods implanted within the corpora cavernosa, which can be bent for sexual activity and straightened for concealment.
Risks and Complications of Priapism Surgery
- Bleeding or hematoma formation
- Damage to the urethra or surrounding tissues
- Scarring or deformity of the penis
- Recurrence of priapism
- Erectile dysfunction
- Reduced penile sensitivity
Postoperative Care and Recovery
After priapism surgery, the patient may experience some pain and swelling. The surgeon will provide specific instructions for postoperative care, which may include:
Taking pain medications as prescribed
Applying ice packs to the surgical area to reduce swelling
Avoiding sexual activity for a specific period, as recommended by the surgeon
Keeping the surgical area clean and dry
Attending follow-up appointments to monitor healing and assess for complications
Frequently Asked Questions
Q: How can I prevent priapism?
A: While not all cases of priapism can be prevented, you can reduce your risk by avoiding illegal drugs, following prescription medication instructions, and seeking prompt medical attention if you experience a prolonged erection.
Q: Can priapism be treated without surgery?
A: Yes, there are non-surgical treatment options for priapism, such as ice packs, medications, and aspiration. However, if these treatments are unsuccessful or if the patient has had multiple episodes of priapism, surgery may be necessary.
Q: Will I be able to have a normal erection after priapism surgery?
A: The ability to achieve a normal erection after priapism surgery depends on the extent of tissue damage and type of surgery performed. Some individuals may experience erectile dysfunction or reduced penile sensitivity after surgery, while others may regain normal sexual function.
Q: Can I have children after priapism surgery?
A: Priapism surgery typically does not affect a man’s ability to have children, as it does not involve the testicles or sperm production. However, erectile dysfunction or reduced penile sensitivity after surgery may make it more difficult to achieve an erection and engage in sexual activity.
Priapism surgery is a viable solution for individuals suffering from persistent erections that have not responded to non-surgical treatments. Understanding the causes, indications, surgical options, and potential risks can help you make an informed decision about your treatment. Remember to always consult with a qualified healthcare professional to discuss your individual needs and concerns.