Introduction to Priapism

Last Updated on: February 15, 2024
Edited By: Alfred

Introduction: Priapism is a delicate medical condition found in males that requires immediate evaluation and has to be attended to immediately. The condition is not uncommon with most medical professionals coming across it on a regular basis, though most of them may not be able to identify with its etiology, classification and management. There are various forms of Priapism that are based on their cause/ etiology.

Definition:

Priapism is a medical condition that is marked by an erect male reproductive organ that continues to be in that state for a long period of time despite the fact that the man is not sexually stimulated during the given time period. The condition is not found in women as it affects only the male reproductive organ. It involves the paired corpora cavernosa, a sponge like part that holds blood when the organ is erect.   In some cases, men could be showing symptoms of stuttering Priapism, in which he could be suffering from recurrent, intermittent and excruciatingly painful erections. Though this condition is generally not fatal and can be treated but in extremely rare condition, Priapism can turn into cancerous states. The malignant condition is caused by metastasis of solid tumors that could be found in the male reproductive organ:

  • From urinary bladder (32 %)
  • Prostrate (28 %)
  • Kidney (17 %)
  • Gastrointestinal tract (8%).

It is not uncommon to observe these tumors arise from testes, lung, liver, bone or from sarcomas. In most cases, the mechanism of malignant priapism could be due to surgeries performed for cancer, tumor and continuous stimulus to the erectile afferent pathways. In some cases, priapism could also be a symptom of a primary tumor in the male reproductive organ.

Risk factors of Priapism:

The overall incidences of Priapism varies

  • Men who are 40 years or above have a higher risk factor than men who are younger than that.
  • Men who are dependent on intracorporal injections to rid themselves of ED at 1% to 17 % at a risk of suffering from Priapism.
  • Similarly children with sickle cell anemia and Thalassemia are more prone to this condition than children who are not.
  • Men who are on unproven and illegal drugs that are believed to treat erectile dysfunction.

Evaluation and Treatment of Peyronie’s disease

Last Updated on: February 15, 2024
Edited By: Alfred

Peyronie’s disease can be diagnosed and its severity evaluated by physical examination. A Physician or even the patient can feel the plaque with his hand, when the male reproductive organ is in a limp or relaxed state. For a complete evaluation, the doctor needs to examine the male reproductive organ, when it is in an erect position. It helps to assess the severity of Peyronie’s disease better.

In order to get the male reproductive organ, the doctor can request the patient to try self stimulation. If the patient has completely succumbed to erectile dysfunction, doctors can inject medicine in the organ. There are cases, where patient refuse to cooperate. In such cases, doctors can advise patients to bring images of the organ from home, while it is in an erect state. The next thing done is ultrasound- it is useful in evaluating circulation of blood within the male reproductive organ. This technique is especially required for patients who are impotent. During impotency, the blood supply to the male reproductive organ is diminished as a result of which, it becomes difficult to assess the blood supply.

Treatment of Peyronie’s disease:

Peyronie’s disease is not a threat to life. Unless the lump turns malignant, men can live with this condition. But severe pain in the organ in an erect state, deformity of the male reproductive organ and inability to have an intercourse can force men into seeking treatment. The exact cause of this condition continues to be unknown. As a result of which, doctors continue to use methods that can help ameliorate the symptoms, if they are not getting completely healed.

In most cases, patients to do aim to have a male reproductive organ that reverts back to its previous anatomic state but the therapy is believed to help patients get back to having a normal, healthy intercourse. In most cases, the twisted organ returns to a state from which it is able to penetrate and reach a climax during the process of coitus. The most common forms of treatments taken for Peyronie’s disease are:

  • Surgery:

Despite people making various tall claims, the only treatment that has proven to be extremely effective is surgery. Removing the lump surgically can help stabilized the condition and prevent the deformity during intercourse. The severity of Peyronie’s disease varies in patients with some of them trying their own ways to treat the condition. As a result of this, doctors are advised to give a gap of a year between diagnosing the condition and performing the surgery as it will help them stabilize the condition. Between this time gap, patients can take pills or other forms of treatment that they think will benefit them.

  • Vitamin E:

There have been cases where vitamin E, given in pill forms, has helped improving cases of Peyronie’s disease.? But there is no study to establish the effect of Vitamin E in this condition.

  • Aminobenzoate potassium (Potaba):

The success of this drug is established, but patients try it nevertheless. Some of the other oral medications that are used are colchicines, tomaxifen and pentoxifyline. But the efficacy of the drugs is not clearly known.

  • Injections:

There have been cases where researchers have tried injecting chemical agents directly into the plaques. Some of the used chemicals are verapamil, collagenase and steroids. In most cases, the twist in the male reproductive organ has decreased or completely disappeared. Collegen has a lot of scope to appear as the future treatment of Peyronie’s disease though steroids are known to have severe side effects.

  • Iontophoresis:

These are painless currents of electricity that act as the medium for delivering agents such as verapamil, below the skin.