The aim of treating priapism is to enhance proper blood flow within the penile vessels, relieve pain and ensure the penis return to its usual flaccid state. There are many approved treatment therapies that work in treating priapism which range between simple aspiration methods to complex surgical therapies. The best treatment for priapism depends on the type of priapism the male patient is suffering from as well as the symptoms they exhibit. Important information such as the length of the period of prolonged penile erection and attributing factors to the condition are also essential in determining the best treatment therapy for a patient.
What Is The Alternative Treatment Method For Priapism?
Treatment for priapism works on different course levels that progress from one method to the next. If one method seems inefficient, then an alternative treatment method is considered that is more successful than the first. The best treatment can be regarded as that which works in favor of the patient, regardless of its complexity.
Patients exude different traits and even react differently to treatment methods. So, at the end of the day, the alternative treatment method for priapism is the therapy that works after an initial treatment method has failed.
Aspiration
This refers to the draining of blood from the corpus cavernosum, which is done on either side of the penis. It is usually the first course of treatment for patients with ischemic priapism. That is priapism caused by trapped blood in the penile blood chambers. The trapped blood is usually drained using a syringe or small needle. To further complete the procedure, a cold saline solution may be injected into the organ and flushed out to relieve pain. It also helps with the removal of the oxygen-deprived blood from the artery in the penis and restores it to its flaccid form. This therapy can be repeated as many times as possible until the erection is no more.
Treatment Through Pharmacological Therapy
This treatment method involves prescription of medications which will help end the prolonged penile erections. One viable drug is phenylephrine, which is injected into the penis, constricting the blood vessels transporting blood into the organ. Due to the constriction of the blood vessels, the blocked veins are able to open up enhancing proper blood circulation in the penis. Possible side effects of phenylephrine include; slow heart rate, arrhythmia, and high blood pressure. Papaverine or phentolamine drugs can also be given as a pharmacological therapy for priapism.
Alternatively, hormone-blocking medications or drugs to help with erectile dysfunction may also be prescribed to treat priapism. However, it is important to note that some of these drugs may cause complications, hence should be taken with caution. If there are any drugs linked to priapism development, then they should not be prescribed. Instead, alternative medication should be given for managing the condition.
For patients with recurrent priapism, diethylstilbestrol or terbutaline may be recommended to treat the condition.
Surgical Procedures for Treating Priapism
The last resort of treating priapism is a surgical procedure to reroute trapped blood so as to enhance blood flow in the penis. This is usually done by use of shunts such as the Winter’s shunt or Quackel’s shunt. During the Winter’s shunt procedure, the tip of the penis (glans) is usually punctured to access the cavernosa, where the blood is trapped. This releases the blood from the penis and it returns to normal circulation. On the other hand, Quackel’s shunt is more complex and involves dissecting into the perineum up to where the corpora meet the spongiosum. Shunting is an important surgical treatment for priapism which helps establish a communication between the corpora cavernosa and corpus spongiosum.
In cases of non-ischemic priapism, surgery may be conducted to insert an absorbable gel that will temporarily inhibit blood flow to the penis. Once that has been done, the surgeon can repair any penile tissue or blood vessel that was damaged due to injury.
Other Methods
Other alternative treatment therapies which can be applied include; methylene blue and ice packs. Methylene blue is a guanylate cyclase inhibitor which is usually injected intracavernously. Ice packs are usually recommended in cases of non-ischemic priapism, which is less risky compared to ischemic priapism. The cold effect of the ice pack helps relieve pain and might also help end the prolonged erection. Priapism linked to sickle cell anemia can be treated by first treating sickle cell anemia. You will be prescribed with additional treatments which help with dealing with the underlying condition. They also aid in reducing the risk of disease-related prolonged erection episodes.
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