Priapism Spinal Cord Injury - The Effect Of SCI On Male Erection
The chronic erection of the penis is called priapism. Clitorism refers to the persistent clitoris erection in females. There is disagreement over the incidence, timing, and levels most likely to be connected with priapism in acute spinal cord injury (SCI).
The Edwin Smith Surgical Papyrus, which is believed to be the earliest medical papyrus ever discovered, describes a patient with a cervical spine fracture complicated by quadriplegia priapism, seminal emission, and urinary incontinence. This is the oldest known case, which dates back to the 17th century BC.
A guarded prognosis was noticed by the Ancient Egyptian doctor who was in charge of the case, who glumly concluded that his patient had "an ailment not to be treated." Following a neck stabbing, a patient with chronic SCI experienced recurring involuntary unwanted erections.
COPYRIGHT_SPINE: Published on https://spinal-injury.net/priapism-spinal-cord-injury/ by Dr. Bill Butcher on 2022-09-28T04:10:08.293Z
According to a study published in Science Direct in 2005, priapism associated with acute spinal cord damage is nonischemic and can be treated conservatively due to its high possibility of healing. Because the data can inform future management decisions, measuring corporal blood gas is significant.
According to the findings, long-term erectile dysfunction is not frequently brought on by conservative care of priapism associated with spinal cord damage. Four of the six individuals with priapism caused by spinal cord injuries had injuries at C5-C7, one at C5-C6, and one at T12.
In 4 individuals, the prolonged erections were treated conservatively, and in 2, intracorporeal phenylephrine irrigation was used. Nonischemic priapism was present in all individuals with corporal blood gas measurements (n = 4).
The priapism went away in all 4 of the patients who had no treatment in less than 5 hours. Four patients experienced recurring episodes during the same admission that went away on their own, two of whom were managed conservatively and two of whom received irrigation.
All 6 patients were contacted by phone to get their long-term results. 5 of the 6 patients have continued to have spontaneous erections to this point (range 3 to 10 years).
A study entitled Priapism in acute spinal cord injury stated that high-flow (non-ischaemic) priapism, in which the blood within the corpus is arterial in character, occurs after acute traumatic SCI. Not all acute SCI patients experience priapism.
However, the study was unable to estimate the percentage of patients who experience priapism based on the literature. Numerous spinal cord diseases, such as acute SCI, transverse myelitis, and postoperative extradural hemorrhage, have been linked to priapism.
Priapism is always accompanied by total motor and sensory paraplegia (American Spinal Injury Association A). There have been reports of priapism after spinal shock. Priapism typically goes away quickly after severe SCI without the need for special care.
Priapism happens immediately after total motor and sensory paralysis; it does not happen later. The presence or absence of priapism helps to pinpoint the time at which the entire spinal cord damage occurred, which has medical and legal ramifications.
Prolonged erection (Priapism) | Healthy Male
Most of the time, priapism is caused by lesions or injuries to the cervical spinal cord. But since the sympathetic outflow to the penis comes from the most caudal part of the spinal cord, priapism can be linked to the conus, which is a lesion at any level of the spinal cord.
The ability to have erections occurs more commonly in men than the ability to have ejaculations. 80% of men with spinal cord injury regain some erectile function by 2 years following their accident, compared to up to 95% of men who have ejaculatory issues.
Priapism is a persistent erection that lasts more than four hours without being stimulated sexually. It is typically painful. When the blood in the penis is unable to drain and becomes stuck, the condition arises. If the illness is not addressed right away, scarring and erectile dysfunction may result.
The studies above prove that the majority of times, priapism is linked to cervical spinal cord lesions and injuries. The conus, a lesion at any level of the spinal cord, can be linked to priapism, nevertheless, as the sympathetic outflow to the penis originates from the most caudal region of the spinal cord.
Priapism typically develops right away after an acute SCI, and in this situation, it normally subsides within a few hours (up to 30 h) of the damage, as it did in our patient. In patients with chronic SCI, however, the clinical course of recurrent or refractory priapism is far more varied.