According to a report from a University Hospital in Southampton, UK, a man remained erect for nine days after a moped accident. A year later, he had no sequelae and regained normal erectile function.
THE ESSENTIAL
- Accident on two wheels, the patient had a hematoma going from the testicles to the base of the penis
- After several days during which he remained erect, the doctors diagnosed him with priapism.
- A blood vessel blocked by the accident prevented the normal flow of blood in the corpora cavernosa
Doctors at Southampton University Hospital, UK, treated a 35-year-old patient with an atypical symptom. After a fall from a moped, it would have remained erect for nine days. His story was published in the Case Reports in Urology (https://www.hindawi.com/journals/criu/2019/3916056/).
During his accident, the man had injured his crotch. Since then, he had a hematoma all over the area from the testicles to the base of the penis and was permanently erect. Other than these symptoms, he reported no other pain. He therefore waited a few days before consulting.
Priapism: an erection lasting more than four hours without any libido
On the day of the appointment, the doctors performed a Doppler ultrasound. This is a two-dimensional medical imaging examination that explores blood flow. Thanks to this, they discovered that this patient suffered from priapism, that is to say an abnormally prolonged erection – more than four hours – and without any libido or sexual stimulation. This is usually caused by a disorder in the drainage of blood through the veins of the corpora cavernosa, i.e. the erectile tissues that become engorged with blood during the erection phase.erection. In this patient’s case, one of his arteries was clogged and was no longer supplying blood to his corpora cavernosa.
Surgery to avoid long-term risks
To treat him, the doctors opted for a quick surgery to prevent him from suffering from long-term erectile dysfunction, which is a potential risk. Finally, the operation to unclog the artery went well and he had no sequelae. However, the 30-year-old was only able to regain normal erectile function a year after his accident. Despite this downside, he can consider himself lucky because the consequences of priapism are sometimes serious. If taken care of too late, the patient may have irreversible lesions going as far as definitive impotence.
Three forms of priapism: venous, arterial and intermittent
There are three forms of priapism: venous, arterial and intermittent. The first is due to a venous dysfunction which results in preventing the irrigation of the cavernous tissues. It is an emergency and men must consult as soon as possible. The second is generally linked to a shock to the perineum or the penis which can create a fistula (an abnormal conduit) between the arteries of the penis and the cavernous tissue. The erection is incomplete but not painful. Finally, intermittent priapism lasts only two to four hours and recurs over the long term. It is also necessary to consult because, in the long term, it can lead to venous priapism.
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