The story is told of a 35yesrs old man who went to a healthcare center with complaints of persistent, painful, unwanted, penile erections. The elderly male medical assistant in charge of the health center got so furious that he sacked the young man from his office. How can someone come and complain of persistent erections when that is a condition that all men are praying for? According to the story, the medical attendant couldn’t understand how an erection lasting for a long time could be a problem especially since every man in his village - young or old - frequently chews a local root to ensure that their manhood stands to attention when required. Even with such constant care and attention, several of them fail to deliver and have to resort to the various alcoholic bitters being advertised all over the country to maintain any decent level of achievement. The young man felt sad and depressed because he really had problems dealing with the condition. What would you do if you had persistent, hard, painful erections which fail to subside even after 2 to 3 hours? What if you are waring tight fitting jeans and sitting on an Accra-Kumasi bus? How about this occurring when you are travelling by air and are asked by the captain to fasten your seat belts? Would this condition allow you to fasten the seat belt comfortably? Is this a medical condition or is it just a social issue? And by the way, is this problem for all ages or it is restricted to certain age groups and what sort of medicines, if any, are there to treat this condition?
Priapism
Priapism refers to the occurrence of persistent, painful erections in men usually lasting for four or more hours. Whilst the ability to have erections is usually desirous in men, priapism is a condition which is often unwanted and also very painful. It is a medical emergency which requires immediate attention.
Priapism is usually not associated with sexual excitement and the erection does not subside after ejaculation, making it a terrible burden to bear. In normal erection, blood flows to the penis making it hard. This blood flows back after sometime and the penis returns to its normal flaccid state. In priapism, blood is prevented from flowing back by the blockade or some other factor. Since the blood does not flow back, the penis is starved of oxygen and this may lead to impaired erections in future or even impotence and other complications if not immediately attended to. This is why priapism is a medical emergency which requires immediate medical attention.
Causes
Priapism appears to occur in two different age groups – children aged between 5-10 years and adults between 25 and 50 years of age. In children, the causes of priapism include leukaemia, trauma to the penis or sickle-cell disease. In adults, the causes include alcohol, prescription medicines, drugs of abuse, trauma to the penis and sickle cell disease. Other rare causes of priapism in adults include gout, malaria and carbon monoxide poisoning. Interestingly, it has been shown that many victims of hanging do get some form of priapism during their last moments of life indicating some neurological and/or spinal cord involvement and possibly explaining why trauma is often implicated in priapism.
Treatment
All cases of priapism require the attention of an UROLOGIST. The patient should immediately go to a hospital. He should inform the doctor of the length of time he has had the erection and the medicines, drugs and alcohol he has been taking. This will allow the physician the opportunity to manage the case properly. Failure to provide such information, including any possible use of alcohol, cocaine or cannabis will greatly compromise the care given to the patient. If the condition is very serious, the doctor may physically use a special syringe to drain blood from the penis. The other surgical procedures may be carried out to prevent complications. If the case is not too serious or if the patient reports to the hospital early, medicines like pseudoephedrine, terbutaline or epinephrine may be given to manage the condition in all cases however, management depends on the judgement of the physician.
A lot of men joke that they wish they could have a permanent erection but any man who has had priapism before knows that it is not a laughing matter at all. It is painful, uncomfortable and usually very embarrassing.
