Therapy and prognosis of priapism

Immediately to the doctor
Is there an erection lasting more than 2 hours, the person should not hesitate to go to a doctor's office. There is an emergency that requires immediate medical attention. Most likely is a urological clinic.


Painkiller
The first thing to be decreed against the frequent pain in low flow priapism painkillers. Then the procedure is a multi-staged plan.


Conservative therapy
In about 60 percent of those helps physical movement or alternating cold and heat packs, swell up from the penis. Especially with high-flow priapism after a SKAT-therapy may also benefit from the drug terbutaline. Vasoconstricting drugs may be injected into the corpora cavernosa. Has the state 30 minutes after taking the tablet or injection is not improved, operational measures are necessary.


Puncture of the cavernous
Initial operational measure is the aspiration of blood from the corpora cavernosa using a syringe. This Cavernosum puncture is carried out either under local anesthesia or general anesthesia. Simultaneously with the extraction of the accumulated blood can also be carried out by rinsing.


There are several surgical procedures


If these measures are not successful, depending on the type of priapism are other surgical procedures available to stop the congestion.

    It may be a connection between the two erectile tissue and the cavernosa urethras(shunt operation) created, so that can drain the accumulated blood.
    A connection between the corpora cavernosa and a vein in the thigh is more than a possibility. Here then the accumulated blood from flowing back through the spongy tissue of the femoral vein into the systemic circulation.
    In a high-flow type, the arterial blood flow into the erectile tissue can be prevented by an artificial closure of penile arteries (selective embolization). Such closure means may gelatin, special adhesives or small will be made in the vessel imposed spirals.


Behavior after surgery
After such an operation are the person for 2 weeks avoid heavy physical stress. Sexual intercourse should be resumed only after consultation with the doctor.


Forecast


For the treatment of priapism within a period of 6 to 8 hours are very good prospects of success. Is delayed beyond the start of treatment longer, the outlook especially for low-flow type are becoming increasingly worse. Operative treatment is required, it may come in 50 to 90 percent of cases of erectile dysfunction.