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The goal of any treatment for priapism is to make the erection go away and to prevent permanent erectile dysfunction.

  • Low-flow priapism is an emergency and should be treated as soon as possible. The duration of the erection affects the severity of erectile dysfunction that can result.
  • High-flow priapism might not require emergency treatment because blood flow to the penis is not reduced. However, only your doctor can distinguish between the two types or priapism.

If you suspect priapism, please contact your doctor immediately and do not attempt any home treatment.

If you have any cardiovascular disease, be sure you tell your doctor before any treatment is performed.

Conservative, first- and second-line treatments

Conservative treatment options include exercise, ejaculation, and ice packs. However, they are rarely successful in resolving prolonged erections caused by low-flow priapism.

First-line treatment options are performed by a doctor. They are suggested for patients who have low-flow priapism of >4 hours duration. These treatment options are less likely to be successful when duration of priapism lasts >72 hours.

Second-line treatment typically refers to penile surgery. Surgery should be considered in cases of emergency, only when conservative and first-line treatment options have failed. Surgery is performed to minimise tissue damage from low blood flow to the penis and to reduce the chance of permanent erectile dysfunction.

Treatment options

Low-flow priapism

Conservative Do not attempt any home treatment. Please contact your doctor immediately.
First-line The penis is numbed, and blood is drawn (aspiration) from the corpus cavernosum. Saline and medication are then injected (irrigation) into the penis to reduce pressure and swelling.
Second-line Penile shunt surgery or penile prosthesis implantation.

High-flow priapism

Conservative Ice packs to the perineum or compression of the injury may bring down swelling.
First-line Block the blood vessel that is causing the problem (artery embolisation).
Second-line Surgical ligation to tie off the ruptured artery: this procedure is a final treatment option if blocking the artery has failed.

Intermittent (stuttering) priapism

First-line The treatment of each acute episode is similar to that of low-flow priapism.
Drug therapy Hormonal therapies and/or antiandrogens or phosphodiesterase type 5 inhibitors, depending on the patient’s medical profile.
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