Priapism

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Classification according to ICD-10
N48.3 Priapism - Painful permanent erection
ICD-10 online (WHO version 2019)

As priapism ( Latinized form of the Greek πριαπισμός priapismós ) or priapism painful is erection of the penis called, the longer lasts two hours and untreated for erectile dysfunction can result. Treatment as immediately as possible is therefore essential to avoid permanent damage.

The female equivalent is called clitorism (although the mere hypertrophy of the clitoris is also called that ).

The name is derived from the Greek god Priapus , the son of Aphrodite and Dionysus , who was depicted as the god of fertility with an oversized, erect penis.

In priapism, both penile cavernous bodies are stiff, but the glans and corpus spongiosum are flaccid. This erection is painful and not associated with any feeling of pleasure. If the priapism is not treated, the erection will not go away spontaneously until after two to three weeks - however , the erectile tissue of the penis will usually be converted into fibrous tissue and the erectile function of the penis will be lost.

to form

There are two forms of priapism:

Low flow type
It is responsible for around 90% of priapism cases. In this form, the reduced outflow of venous blood from the erectile tissue (Latin: corpora cavernosa ) of the penis leads to prolonged stiffening.
High flow type
This leads to an increased supply of arterial blood.

The low-flow type is much more dangerous than the high-flow type, as the smooth muscle structure is insufficiently supplied with oxygen. If the undersupply lasts too long, permanent hypoxic damage to the muscle tissue occurs.

causes

In more than half of the cases in which one speaks of idiopathic or primary priapism, a cause cannot be given . In 2008, scientists at the University of Texas in Houston accidentally found that genetically modified mice lacking an enzyme to break down adenosine had their genitals permanently erect. This indicates that the lack of this enzyme is causing the permanent erection.

Possible causes of the secondary form are:

therapy

Priapism is an emergency that must be dealt with quickly according to a step-by-step plan. First, an attempt must be made to withdraw as much blood as possible from the erectile tissue. Conservative therapy involves physical exercise or muscle work. If this does not lead to success, alpha-adrenergic substances such as etilefrine are injected into the erectile tissue while the blood pressure is continuously monitored . Another option is to rinse the corpus cavernosum with a highly diluted adrenaline solution. Finally, operative methods can also be considered. Appropriate pain therapy must always be carried out.

Priapism is best treated in a urology clinic emergency room. With professional therapy within a maximum of twelve (better four to six) hours, permanent erectile dysfunction can be prevented in up to 90% of cases.

Long-term consequences

The long-term consequences (especially as a result of late treatment) can result in penile deviation , loss of erection and sometimes even gangrene .

Web links

Wiktionary: Priapism  - explanations of meanings, word origins, synonyms, translations

References

  1. ↑ a b c d Title 24.4 in Brigitte Woggon : Treatment with psychotropic drugs . 2nd, completely revised and expanded edition 2005. © Verlag Hans Huber, Hogrefe AG, Bern 1998/2005. ISBN 3-456-83538-8
  2. ↑ Toxinfo database entry on Latrodectus sp. the toxicological department at Klinikum rechts der Isar, Munich
  3. ↑ FDA Drug Safety Communication: FDA warns of rare risk of long-lasting erections in males taking methylphenidate ADHD medications and has approved label changes. (PDF; 108 kB) Safety Announcement. US Food and Drug Administration (FDA), December 17, 2013, accessed April 11, 2015 .
  4. ↑ See Roche Lexicon Medicine, 4th edition, Munich 1999, p. 1366