» Priapism - Causes, Diagnosis, Treatment
Priapism - Causes, Diagnosis, Treatment
Priapism - Causes, Diagnosis, Treatment
Priapism is a pathological condition characterized by the appearance of prolonged erection unrelated to sexual stimulation. Usually, this condition is accompanied by painful sensations in the root of the penis. Unlike a true erection, tense in the main cavernous body, the head of the penis is still relatively soft. Urination is not violated. Sexual intercourse does not bring relief. Priapism is usually begins at night during sleep.
The term originated by the name of the Greek god Priapus - god of gardens and fertility. He was also the god of debauchery and his penis was in a constant state of erection. Priapism can occur in adults men and children.
Causes of priapism can be varied:
Priapism can be psychogenic. In this case, it occurs in patients with mental illness, epilepsy, patients with neuroses.
Neurogenic priapism occurs in diseases of the brain and spinal cord - trauma, tumors, encephalitis.
Somatic priapism occurs in patients with blood diseases (leukemia, sickle cell anemia), in patients with malignant diseases, in some allergic diseases.
Priapism is the result of intoxication of alcohol, cocaine, psychotropic drugs.
Medical priapism developing in the use of certain drugs (stimulants, antidepressants, drugs used to treat erectile dysfunction).
Idiopathic priapism. The reason for this type of disease remains unknown.
In the mechanism of priapism plays a major role in the imbalance of vascular cavernous bodies of the penis. At the same time the inflow of arterial blood prevails over the outflow. To join this process and a violation of the venous outflow. As a result, the penis as it is excluded from the systemic circulation. Blood stagnates in it. It starts with oxygen starvation of tissues. During prolonged ischemia (insufficient blood supply) start degenerative changes of cells. And when there are more than three days of priapism is irreversible damage to the tissues of the penis, leading to the loss of his erectile dysfunction, necrosis and gangrene. The penis becomes cyanotic, the head acquires a violet color, and then turns black. Then the penis should be deleted. Such a mechanism of priapism is ischemic priapism, or with poor blood supply.
For injuries of the perineum, the pelvis, the mechanism of priapism may be different. It is called priapism with a good blood supply (non-ischemic). If the injury occurs as a result of a direct connection between the artery and the cavernous bodies of the artery in the cavernous body is constantly supplied arterial blood, which has no time to be removed by the venous system. An erection. If the flow priapism joins an infection occurs caverns - an inflammation of the cavernous bodies. Priapism as already mentioned, occurs at night during sleep. The resulting erection is not terminated after sexual intercourse or masturbation. Urination is not violated. The head of the penis and urethra remain intact. Pain in the root of the penis occurs later.
Diagnosis is based on a survey of priapism, the appearance of the genitalia. Find out what other diseases the patient is suffering, the circumstances of a persistent erection. Sometimes an ultrasound performed vessels of the penis. To clarify the diagnosis can be performed puncture of the corpora cavernosa. In ischemic priapism, blood type, obtained by a puncture, it is dark in color. If priapism with a good blood supply to the coloring of scarlet blood. In the case of accession of infection and pus kavernita receive the purulent contents.
The treatment of priapism. Treatment of priapism should be started immediately. Therefore, when a complaint should immediately seek medical attention and is best to call an ambulance.
Initially, conservative treatment of priapism. The penis is cooled by means of hot-water bottles with ice. Carry a puncture of the cavernous bodies under local anesthesia using a special needle. Through this needle drained the excess blood, the cavernous body is washed up scarlet blood. Perhaps a drug cupping priapism (phenylephrine). Puncture gives good results in essentially the first day of the onset of the disease. If possible, find out the cause of priapism, and act on it.
If conservative methods fail to eliminate the priapism, or relapse of the disease, surgical treatment is carried out. The aim of surgical treatment improved outflow of blood from the corpora cavernosa. This creates a connection between the cavernous bodies and other veins. With timely treatment of priapism, and the results are good erectile function over time is preserved. In severe cases it may be persistent impotence. When gangrene and necrosis of the penis should be deleted. In this case, after some time performing plastic surgery and joint replacement.