Not all post-trauma erectile dysfunctions involve an inability to gain a
sufficient erection, however. It is possible to experience priapism. A priapism
is where an erection will not go down, and in some cases can be painful.
There are two forms of priapism, low-flow and high-flow:

  • Low-Flow Priapism. This is where blood becomes trapped in the erection chambers. This is the most common type of priapism post-trauma. It can occur in healthy men without a known cause however. Low-flow priapism is more likely to be painful.
  • High-Flow Priapism. High-flow priapism is less common and less likely to be painful. It results from a ruptured artery due to direct genital trauma, preventing proper bloodflow.

Priapism can also be caused factors other than trauma. It is a possible side-effect
of erection drugs such as Viagra, carbon monoxide poisoning, illicit
drug use (in particular marijuana and cocaine), as well as some spider bites.
Sickle cell anemia is also commonly associated with priapisms: it’s estimated
that around 42% of adult men with sickle cell will eventually be affected by
some degree of priapism.

Priapism Treatment
Treatment for priapism depends a little on the duration and severity of the
priapism. With all treatment however the objective is not only to cause theice-cube
erection to resolve, but also preserve future erectile function as best as
possible. Treatments may include:

Ice Packs. Ice applied to the penis and/or perineum may
in some cases be all that’s needed to reduce swelling.
This is less likely with more severe priapisms however.

Aspiration. After anaesthetising the genital region,
doctors insert a fine needle into the penis’ chambers and
drain blood to reduced pressure and swelling.

Intracavernous Injection. Similar to Aspiration above, only in this case instead of removing blood a drug is injected, which causes veins to narrow, reducing penile bloodflow and hopefully allowing swelling to subside. This is only used in cases of low-flow priapism, and is less common in cases of trauma.

Surgical Shunt. Also used for low-flow priapism, a shunt (small metal passageway) is surgically inserted into penile blood chambers to divert bloodflow and allow circulation to return to normal.

Surgical Ligation. Used in high-flow priapism cases where the artery rupture is significant, doctors will ligate (tie off) the artery below the rupture to restore normal bloodflow.

NB. It should go without saying, but please do not attempt any of these priapism treatments yourself, or with assistance of a non-medically trained partner. Priapism can be serious, and both the condition and treatments may potentially cause further damage and trauma. If you believe you may be experiencing priapism seek emergency medical assistance immediately.

Jamie Robertson