Priapism is when you have an erection longer than 4 hours. The erection happens without sexual arousal. The cause of priapism is not always known. Priapism can be painful and lead to permanent tissue damage.

What are the types of priapism?

  • Low-flow priapism (ischemic) is when the blood flow in your penis becomes blocked. You may also have a painful erection that comes and goes over many hours. Low-flow priapism is an emergency and must be treated immediately.
  • High-flow priapism (non-ischemic) is when too much blood flows into your penis. You have an erection for 4 hours or longer but it is usually not painful.

What increases my risk for priapism?

  • Medical conditions, such as sickle cell disease, blood disorders, or leukemia
  • Medicines, such as blood thinners, and those that treat erectile dysfunction, high blood pressure, or mental health conditions
  • Trauma, such as a groin, back, or spinal cord injury, or an injury during sex
  • Drugs, such as cocaine and marijuana
  • Alcohol in large amounts

How is priapism diagnosed?

  • Blood and urine tests may show what is causing your condition, or how serious it is.
  • An ultrasound may be done to check the blood flow in your penis.

How is priapism treated?

Treatment will depend on the type of priapism you have. High-flow priapism often goes away on its own. You may need any of the following:

  • Medicines may help regulate your hormone levels. You may also need an injection in your penis to help improve blood flow.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Aspiration is done to remove blood from your penis. Your penis is numbed and blood is removed with a needle.
  • Surgery may be done to place a shunt in your penis. The shunt allows blood to pass through and out of your penis. Surgery may also be done to stop blood flow to your penis for a short time.

How can I manage my symptoms?

Apply ice on your groin for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps decrease blood flow to your penis and relieve your erection.

How can I help prevent priapism?

  • Manage medical conditions that increase your risk for priapism. Take your medicines as directed.
  • Do not drink alcohol. It increases your risk for priapism.
  • Do not use drugs. Talk with your healthcare provider if you use drugs and need help to stop.

When should I seek immediate care?

  • You have an erection for more than 4 hours.
  • You have a painful erection that comes and goes over many hours.
  • You have trouble urinating.

When should I call my doctor?

  • You have problems getting an erection after treatment.
  • You have any questions or concerns about your condition or care.