Why Does Priapism Occur?

Priapism is a medical emergency that is characterized by painful erections that lasts for hours. This erectile dysfunction disorder should not be taken lightly, as it can result in damaged penile function if not treated early enough. At worst, a penile amputation may be considered as a last result when the glans develops a dry necrosis. In the case of priapism, blood is usually trapped within the vessels of the penis. When there is no good blood circulation in the penis, the cells and tissues within the organ start to die as they lack oxygen. This results in tissue scarring as well as damage of penile function and can lead to permanent erectile dysfunction. There are a number of factors which can cause priapism, but its actual pathogenesis is not well understood.

While an erection normally occurs due to physical or psychological simulations, prolonged penile erections (priapism), are far from sexual stimulations. There are a couple of underlying factors which cause priapism and they include;

  • Injury to genitals.
  • Spinal cord injuries.
  • Alcohol and other drug abuse (cocaine, heroin, and ecstasy).
  • Certain medication including antidepressants, antihypertensives, alpha blockers, blood thinners, hormone therapy drugs and medication to help with erectile dysfunction such as Viagra and Levitra.
  • Blood disorders such as leukemia and sickle cell anemia.
  • Spider bites or scorpion stings.

Why Does Priapism Occur?

Why Does Priapism Occur?

There is no obvious cause of priapism as it can be triggered by a number of factors. The causes of priapism can be some of the medical explanations of why this condition occurs. Other than that, the main phenomena behind priapism can be attributed to the two major forms of priapism i.e. low-flow priapism and high-flow priapism. As for stuttering priapism, it is often a development of ischemic (low-flow) priapism, which is intermittent. Blood disorders result in priapism because they either cause blood to thicken or make red blood cells lose their flexibility and mobility. When blood does not flow out of the penis properly, it can also lead priapism, in particular, ischemic priapism.

For drug-induced priapism, the best explanation for the occurrence can be related to the interaction the drugs have with the erectile functionality. Priapism is usually a possible side effect of various medications. In the case of drugs which help with erectile dysfunction, if too much dosage is given than required, it can result in prolonged painful penile erections.

There are three major forms of priapism and each is different from the other. High-flow or non-ischemic priapism is caused by an injury to the artery, which supplied blood to the penis. This type of priapism is rare and barely causes painful erections, which usually subside on their own. There is also low-flow or ischemic priapism which is caused by trapped blood in the penis blood chambers. This type is usually more painful and has long-lasting erection periods which can cause complications in the penis. It is a medical emergency that needs to be attended to as soon as possible before any irreversible damage is done. Finally, we have stuttering priapism, which is even a rarer condition that is characterized by recurrent episodes of prolonged penile erections.


It is important to understand why priapism occurs as it paves the way to prevent the condition from occurring. Other than that, doctors value the information as it helps them assess the best treatment for each type of priapism. Different forms of priapism will require different treatment therapies with regards to their symptoms and danger levels. For less severe priapism (high-flow), the best treatment is blocking/tying the artery causing the problem. For low-flow priapism, treatment can be offered through oral drugs, injections to drain blood or ice packs and pain medication to help with the swelling and pain. Priapism can also be treated by managing the underlying conditions, which triggered the disorder in the first place.

The occurrence of priapism is not fully understood as there is little information about the condition. Regardless, we know a few causes, which lead to its occurrence and understanding these causes extensively can help in building the body of knowledge of priapism.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 29, 2019

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