Prolonged Erections (Priapism): Causes and Effects

The medical term for prolonged erections is Priapism. According to the American Medical Association, this is defined as a prolonged erection developing in the absence of sexual stimulation and unrelieved by ejaculation. The time period for an erection to be labeled a priapism is over 4-6 hours. 

There are two main types of Priapism; venocclusive and arterial. It is important for you and your doctor to know which category your condition fits into because the treatment of priapism depends on the type you are experiencing. Venocclusive is an emergency situation while arterial is not. 

Venocclusive priapism is caused by a failure of blood to drain from the penis. This can be caused by prolonged blockage of the draining veins. Venocclusive priapism may be caused by paralysis of the erectile smooth muscle which is generally due to drugs or toxins or from sludging of blood which happens due to blood disorders with subsequent prevention of venous drainage. 

Arterial priapism, the second type of prolonged erection, results from unregulated inflow of arterial blood into the penis. This type of prolonged erection happens because of some sort of trauma to the penile area. 

There are several potential causes of venocclusive priapism, this first form of prolonged erection and they include, penile injection therapy usually used by men for erectile dysfunction, medications including drugs for depression, psychiatric conditions, certain blood pressure medications, cocaine, and blood disorders including sickle cell disease as well as others. Sickle cell disease is among the common causes of prolonged erection in children and teens. 

The patient with prolonged erectile issues usually complains that getting an erection is painful. Men with arterial priapism, however, have an erection that is usually less than fully rigid and painless. Men with arterial priapism usually report some sort of blunt injury early in life.