Priapism Spinal Cord Injury - Causes, Symptoms, And Management
Understanding priapism spinal cord injury is crucial for those affected by this condition and the medical professionals who treat it.
Author:Dr. Bill ButcherDec 07, 202324.4K Shares382.5K Views
Priapism, a condition characterized by prolonged and often painful erections that aren't related to sexual arousal or stimulation, can sometimes be linked to spinal cord injuries.
This unusual and potentially distressing medical phenomenon is not only physically uncomfortable but also raises questions about the intricate connections between the nervous system and sexual response.
Understanding priapism spinal cord injuryis crucial for those affected by this condition and the medical professionals who treat it.
In this article, we will delve into the complexities of priapism resulting from spinal cord injuries, exploring its causes, symptoms, treatments, and implications.
What Is Priapism?
To put it simply, priapism is an extended penile erection. When a complete or partial erection persists for hours without being triggered by sexual activity.
Ischemic priapism and nonischemic priapism are the two most common forms. A medical emergency exists when ischemic priapism occurs.
Although priapism is very rare, it is rather frequent in those who suffer from sickle cell disease. In most cases, erectile dysfunction (an inability to acquire or keep an erection) may be avoided by receiving therapy for priapism as soon as possible.
Although priapism often affects men in their 30s and older, it may develop in young boys with sickle cell illness.
Types Of Priapism
Some examples of priapism are:
Ischemic Priapsty (poor Blood Flow)
When blood pools in the erection chambers (corpora cavernosa) and is unable to drain, a condition known as low-flow priapism develops.
The majority of healthy individuals will experience this at some point in their lives, but those with sickle cell disease, leukemia, or malaria are also at risk. It is the most typical kind of priapism.
Recurrent (stuttering) Priapism
One kind of low-flow priapism is stuttering priapism. An erection that lasts a long time may come and go many times. It might return more often and become more excruciating each time.
Non-ischemic (high-flow) Priapism
High-flow priapism is less common than low-flow priapism and often does not cause any discomfort.
An injuryto the penis or the perineum (the region between the scrotum and the anus) may be to blame. Injuries to the penile area result in unrestrained blood flow, resulting in a persistent erection.
What Is Priapism Spinal Cord Injury?
An ongoing penis erection is known as priapism. Clitorism refers to the continuous erection of the clitoris in women.
It is unclear how often or when priapism occurs after an acute SCI, or what level(s) of damage are linked to it. Some males with acute traumatic SCI develop priapism.
It is unknown what percentage of males with acute SCI have priapism. Any damage to the spinal cord, from the foramen magnum to the conus, might cause priapism.
Complete motor and sensory paraplegia(as defined by the American Spinal InjuryAssociation's A classification) is invariably accompanied with a turgid semi-erect or erect priapism.
When total SCI happens, or very soon after, priapism most often occurs. This case exemplifies the condition known as priapism with increased arterial flow.
Priapism resolves on its own within a few hours, but may take up to 30 hours following a spinal cord injury. Fortunately, it very rarely needs medical attention.
The medicolegal ramifications include the possibility that a complete SCI resulted from a failure to immobilize the spine during the pre-hospital or early hospital phases of care if priapism and complete motor and sensory paraplegia were later identified.
priapism in spinal cord injury
Causes And Mechanisms Of Priapism In Spinal Cord Injury
Priapism is a condition characterized by prolonged and often painful erections that can occur without sexual arousal. In the context of spinal cord injury (SCI), priapism can be a distressing complication with various causes and underlying mechanisms.
Understanding the factors contributing to priapism in SCI is crucial for effective management and prevention. Here, we delve into the causes and mechanisms of priapism in spinal cord injury cases.
Neurological Disruption
One of the primary mechanisms behind priapism in SCI is the disruption of the normal neurological pathways that regulate penile blood flow.
The spinal cord plays a crucial role in transmitting signals between the brain, nerves, and blood vessels involved in erection and detumescence. In SCI, these pathways can be damaged, leading to uncontrolled blood flow to the penis.
Autonomic Dysfunction
SCI often leads to autonomic nervous system dysfunction. This system controls involuntary bodily functions, including the regulation of blood vessel dilation and constriction.
In priapism associated with SCI, an imbalance in the autonomic nervous system can result in sustained erection due to inadequate constriction of penile blood vessels.
Impaired Reflex Arcs
Reflex arcs, which involve sensory input, spinal cord processing, and motor output, regulate various bodily functions.
In SCI, these reflex arcs can be disrupted, affecting the normal mechanisms that trigger erection and subsequent detumescence. This disruption can contribute to the persistence of priapism.
Medications And Blood Disorders
Some individuals with SCI may be on medications that can increase the risk of priapism, such as medications used to manage spasticity or pain.
Additionally, blood disorders, such as sickle cell disease, are associated with priapism in both SCI and non-SCI populations.
Venous Outflow Obstruction
Priapism can also result from venous outflow obstruction, which prevents blood from leaving the penis.
In SCI, venous outflow obstruction can be caused by blood clots or damaged blood vessels, further contributing to prolonged erections.
Psychological Factors
The psychological impact of SCI, including anxiety and depression, can indirectly contribute to priapism.
Psychological stress and anxiety can lead to sympathetic nervous system overactivity, affecting the balance between sympathetic and parasympathetic systems that regulate penile blood flow.
Symptoms And Diagnosis Of Priapism In Spinal Cord Injury
Priapism, characterized by prolonged and often painful erections unrelated to sexual stimulation, can be a distressing complication in individuals with spinal cord injury (SCI).
Prompt recognition and diagnosis are crucial for effective management and prevention of complications.
Symptoms Of Priapism In SCI
- Persistent Erection -The primary symptom of priapism is a prolonged and sustained erection lasting for hours beyond sexual stimulation or arousal. This erection can be painful and uncomfortable, impacting an individual's overall well-being.
- Pain and Discomfort -Priapism often leads to pain, discomfort, and tenderness in the penile region. The continuous engorgement of blood vessels can result in tissue damage and pain.
- Swelling and Tenderness -The affected penis may become swollen and sensitive to touch due to the accumulation of blood in the erectile tissues.
- Urinary and Sexual Dysfunction -Priapism can cause urinary retention and difficulty urinating due to pressure on the urethra. Additionally, the persistent erection can interfere with normal sexual function.
- Changes in Penis Appearance -The penis may appear visibly engorged, swollen, and elongated due to the prolonged blood flow.
Diagnosis Of Priapism In SCI
- Clinical Examination -A healthcare provider will perform a thorough physical examination to assess the appearance, tenderness, and consistency of the penis. They will also inquire about the duration of the erection and associated symptoms.
- Medical History -The patient's medical history, including any history of spinal cord injury, medications, and underlying medical conditions, will be evaluated to determine potential risk factors for priapism.
- Ultrasound Imaging -Color Doppler ultrasound can help assess blood flow in the penis and identify any blood clot or blockage in the penile blood vessels.
- Blood Tests -Blood tests may be conducted to rule out underlying medical conditions or blood disorders that could contribute to priapism.
- Neurological Assessment -Since priapism can be linked to disruptions in neurological pathways, a neurological examination may be performed to assess the level and extent of spinal cord injury.
- Aspiration and Blood Gas Analysis -In some cases, a healthcare professional may perform an aspiration procedure to withdraw blood from the penis for analysis. This can help determine the type of priapism (ischemic or non-ischemic) and guide treatment decisions.
Early diagnosis and intervention are essential to prevent potential complications of priapism, such as tissue damage, erectile dysfunction, and infection.
If an individual with spinal cord injury experiences symptoms of priapism, it's important to seek medical attention promptly to receive appropriate treatment and prevent long-term adverse effects.
Priapism Treatment
All priapism treatments aim to eliminate your erection while preserving your potential to have erections in the future. If you suspect you have priapism, do not try to cure it yourself. Get immediate assistance as soon as possible.
Decongestants, such as phenylephrine (Sudafed PE®), may be prescribed by your doctor at first. They may help reduce erections by decreasing blood flow to the penis. Decongestants are most effective four to six hours after the onset of priapism.
Other reatments include:
- Aspiration (draining extra blood from your penis) - Your penis will be numbed initially by a provider. They will then drain oxygen-depleted blood from your penis using a tiny needle and syringe to relieve pressure and swelling. They may have to repeat this method many times until your erection disappears.
- Intracavernous injection of medicines into the corpus cavernosum - A physician will inject medicine (alpha-agonists) into your penis using a little needle. Alpha-agonists produce artery constriction. This lowers blood supply to your penis, resulting in less swelling. Low-flow priapism is treated by intracavernous injection.
- Packs of ice- An ice pack applied to your penis and perineum may help minimize swelling.
- Surgical ligation -If an artery ruptures due to an accident, a urologist may surgically tie off (ligate) the wounded artery and restore normal blood flow. High-flow priapism is treated surgically.
- Surgical shunt- A urologist may build a conduit (shunt) into your penis to redirect blood flow and restore normal circulation. A surgical shunt is used to treat low-flow priapism.
You may feel self-conscious or ashamed if you have a painful erection, and you may believe you can attempt some of these treatment alternatives at home first. However, if you have priapism symptoms, you should contact a doctor as soon as possible.
People Also Ask
What Is The Connection Between Priapism And Spinal Cord Injury?
The connection between priapism and spinal cord injury lies in the disruption of nerve signals that control blood flow to the genitals. This disruption can lead to persistent and painful erections.
How Is Priapism Treated In Spinal Cord Injury Cases?
Treating priapism in cases of spinal cord injury often involves addressing the underlying cause. This may include medications, drainage procedures, or surgical interventions to alleviate the condition and prevent further complications.
Are There Preventive Measures For Priapism In Spinal Cord Injury Patients?
Preventive measures for priapism in spinal cord injury patients may involve regular medical check-ups and managing the underlying spinal cord injury. Maintaining overall healthand following medical advice can contribute to reducing the risk of priapism.
What Should Someone With A Spinal Cord Injury Do If They Experience Priapism?
If someone with a spinal cord injury experiences priapism, it's important to seek immediate medical attention. Priapism can be a serious condition that requires prompt treatment to prevent complications and alleviate discomfort.
Final Thoughts
The association between priapism and spinal cord injuries sheds light on the intricate and multifaceted nature of the human body's physiological responses.
While priapism stemming from spinal cord injuries can be distressing and uncomfortable, medical advancements continue to provide insights and solutions for those affected by these conditions.
It's crucial for individuals with spinal cord injuries to be aware of the potential risks of priapism and to seek prompt medical attention if such symptoms arise.
Through further research, improved treatments, and enhanced awareness, medical professionals and individuals alike can work towards managing and minimizing the impact of priapism spinal cord injury, thereby contributing to a better quality of life for those affected.
Dr. Bill Butcher
Author
With more than two decades of experience, Dr. Bill Butcher aims to provide a repository for educational materials, sources of information, details of forthcoming events, and original articles related to the medical field and about health subjects that matter to you. His goal is to help make your life better, to help you find your way when faced with healthcare decisions, and to help you feel better about your health and that of your family.
Bill received his medical degree at Boston University School of Medicine and spent his entire career helping people find the health and medical information, support, and services they need. His mission is to help millions of people feel fantastic by restoring them to optimal health.
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