When a Good Thing Turns Bad

An erection that lasts longer than a few hours can be very bad news.

An erection that lasts too long? "No such thing!" you say.

Sorry guys, but once again, you definitely can get too much of a good thing. Priapism—a prolonged erection unrelated to physical or mental stimulation—is no prize. Within an hour or so, your penis may begin to hurt, and within six hours permanent damage leading to impotence can begin. An inappropriate erection isn't a cause for celebration, it's an invitation to the emergency room.

What in the world can cause good news to become so bad? Less commonly, an injury to the area between your scrotum and your anus (actually an extension of your penis inside your body) may rupture arterial vessels carrying blood into the penis, causing it to engorge. Arterial priapism usually isn't immediately dangerous, and it can usually be corrected without too much difficulty. But it's still reason to see your doctor ASAP.

More often, an erection persists because veins that carry blood from the penis are squeezed shut, trapping blood inside. Tissue throughout the body, and especially in the penis, depends on a steady flow of fresh blood to supply it with nutrients and oxygen. As a result, priapism caused by vein shutdown can be very dangerous indeed.

Only in about half the cases do we know what causes vein-induced priapism. Some drugs—such as sedatives, antidepressants, blood thinners, and high-blood pressure medications—have been implicated, and blood disorders such as sickle-cell anemia are known to increase the risk. Reports also link extended sexual activity to the disorder. Medical researchers have also noticed that priapism appears to run in families, although we've not found just what it might be that's passed along in a father's genes.

As long as man with a prolonged erection gets help promptly, the prognosis is good. In the case of an arterially induced problem, clotting may be encouraged or a relatively simple surgical correction may be called for.

When veins shut down, the situation is more urgent. There are drugs that open things up, and ice packs may help. In some cases, the old blood may need to be removed with a needle in order that fresh may flow in. Given soon enough, treatments are almost always effective.

If you have an erection that lasts longer than a few hours, doesn't go away in the absence of stimulation, and hurts, don't worry about embarrassment. Worry about your future. The important thing is to get help quickly.


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