Many men believe that a permanent or prolonged erection (up to several hours), this is a sign of a real man. Normally, men can manifest spontaneous erection in the morning and afternoon. However, the state of prolonged erections may indicate certain diseases. Priapism occurs suddenly. Pathological erection is accompanied by severe pain in the penis, the sacral region. The penis becomes tense, sharply painful, skin become bluish tint. The direction of the penis – is arcuate, at an acute angle to the stomach. The head of the penis and the corpus cavernosum of the urethra – are the soft, unstressed.
Study author Dr. Daniel Stein said, that we were talking not about massive problem. “There are patients who suffer from this disease. Its symptoms and visible signs appear after taking Viagra or other generic. Sickle-cell disease – is a consequence of improper drug administration, just a side effect does not occur. All generic drugs are tested, so to talk about the exact diagnosis, caused by reception of medicines we cannot”. The pathogenesis of priapism is defined by inadequate inflow and outflow of blood in corpora cavernosa. There are two types of abnormal erection: arterial and veno-occlusive.
Causes of Priapism
Many doctors of ambulance US say that for a year, according to statistics, they have received more than 10,000 patients with the disease. Of this number, it is not known who addresses again, and who is ill for the first time. The presence or absence of pain in the penis is one of the diagnostic features that distinguish veno-occlusive priapism from the blood one. In addition to general clinical methods in the differential diagnosis of these types of priapism are using data and Doppler blood gasometry aspirated from the corpora cavernosa.
During arterial priapism ultrasound picture would indicate a violation of the integrity of the arteries of the penis. The partial pressure of oxygen (pO2) and blood pH does not change. Veno-occlusive priapism is characterized by hypoxia, acidosis. Long-term local hypoxia (anoxia) of the cavernous tissue is a damaging factor leading to erectile tissue sclerosis and eventually to the development of impotence. There are more than 50 of etiological factors of priapism.
How does the Disease
Dr. Stephen Freedland, associate professor of surgery at the Duke University School of Medicine, said, that the problem may occur not because of Viagra and other pills. On average, these diseases are found every week, but the cause is not Viagra. Priapism must be distinguished from satyriasis in which is stored and sharply increased sexual desire; sexual intercourse is accompanied by orgasm and ejaculation. The diagnosis is not difficult and is based on the survey data of the patient (the duration of erection and pain, alcohol, drugs, drugs, trauma, etc.) and inspection. Laboratory and instrumental methods are used to determine the form, as the method of medical cupping of the disease depends on its type.
The most important and serious complication – is erectile dysfunction. The duration of priapism is the most important prognostic factor. Fibrosis (seal) of the penis that develops against the backdrop of prolonged priapism, and is substituted cavernous tissue of the penis to the scar, is the main cause of erectile dysfunction. Recurrent (night, returnable) priapism is a type of ischemic priapism, in which episodes of unwanted painful erections are interspersed with short periods of extinction and re-appearance at regular intervals, usually at night. The reasons are the same as in ischemic illness, and they can occur by psychogenic factor.
Treatment of Priapism
Dr. Stephen Freedland said that the treatment could be done, but it was very painful. Treatment should be directed to the relief of the disease, removing pain and preservation of erectile function. It is necessary to find and eliminate the root cause that led to priapism. When arterial priapism produce ligation of the damaged vessel, with veno-occlusive – are treated with topical lotions cold, ice; prescribe painkillers and sedative, antispasmodic. Various types of novocaine blockade (Presacral, epidural, perirenal blockade of the spermatic cord) are used. Conservative measures can be effective only if their execution in the early stages of the disease (6-12 hours).
In the absence of a positive effect of conservative treatment measures is applied decompression corpora cavernosa by a puncture with aspiration of penile blood and followed by washing with saline supplemented with alpha-agonists. This leads to a decrease in blood supply to the tissues of the penis. Scientists believe this method is the “gold standard” of the start of treatment of acute ischemic priapism, regardless of the timing of the disease. From invasive techniques are executed bypass surgery. Their purpose – is the improving the venous outflow from the corpora cavernosa through the venous system by intact greater saphenous femoral vein (sapheno-cavernous anastomosis) or via subcutaneous veins of the penis (spongy-cavernous anastomosis, spongy-cavernous fistula).