Treatment

Ischemic priapism

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

• Aspiration decompression. 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 medication, such as phenylephrine, might be injected into your 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, increasing blood flow out of the penis. 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.
• Surgery or other procedures. If other treatments aren't successful, a surgeon might perform other procedures to drain blood from the penis or surgery to reroute blood flow so that blood can again move through your penis.

If you have sickle cell disease, 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.

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. You might also need surgery to repair arteries or tissue damage resulting from an injury.