Ischemic priapism

Ischemic priapism — the result of blood not being able to exit the penis — is an emergency situation that requires immediate treatment. This treatment usually begins with a combination of draining blood from the penis and using medications.

Therapies

Excess blood is drained from your penis using a small needle and syringe (aspiration). As part of this procedure, the penis might also be flushed with a saline solution. This treatment often relieves pain, removes oxygen-poor blood and might stop the erection. This treatment might be repeated until the erection ends.

Medications

A sympathomimetic medication, such as phenylephrine, might be injected into the penis. This drug constricts blood vessels that carry blood into the penis. This action allows blood vessels that carry blood out of the penis to open up and allow increased blood flow out. This treatment might be repeated several times if needed. You will be monitored for side effects, such as a headache, dizziness and high blood pressure, particularly if you have high blood pressure or heart disease.

Surgical or other procedures

If other treatments aren't successful, a surgeon might perform surgery to reroute blood flow so that blood can move through your penis normally.

If you have sickle cell anemia, you might receive additional treatments that are used to treat disease-related episodes.

Nonischemic Priapism

Nonischemic priapism often goes away with no treatment. Because there isn't a risk of damage to the penis, your doctor might suggest a watch-and-wait approach. Putting ice packs and pressure on the perineum — the region between the base of the penis and the anus — might help end the erection.

Surgical or other procedures

Surgery might be necessary in some cases to insert material, such as an absorbable gel, that temporarily blocks blood flow to your penis. Your body eventually absorbs the material. Surgery might also be necessary to repair arteries or tissue damage resulting from an injury.