Priapism Treatment in Singapore

Experiencing a prolonged, painful erection can be distressing and requires immediate medical attention. Priapism is a urological emergency that affects men of various ages, causing persistent erections unrelated to sexual stimulation. A Singapore urologist provides comprehensive emergency and follow-up care for priapism, helping patients manage this condition effectively while preserving erectile function. Our MOH-accredited specialists understand the urgency and sensitivity of this condition, offering prompt, professional treatment in a discreet environment.

Priapism treatment encompasses various medical interventions designed to resolve abnormal, prolonged erections lasting more than four hours. This condition occurs when blood becomes trapped in the penis, unable to drain properly. Without prompt treatment, priapism can cause permanent damage to penile tissue and lead to erectile dysfunction.

There are two main types of priapism requiring different treatment approaches. Ischaemic (low-flow) priapism is the more common and serious form, occurring when blood cannot leave the penis. Non-ischaemic (high-flow) priapism happens when too much blood flows into the penis, typically following trauma. Treatment aims to restore normal blood flow, relieve pain, and prevent long-term complications.

The urgency of treatment cannot be overstated – ischaemic priapism is a medical emergency requiring intervention within 4-6 hours to prevent permanent tissue damage. Our urology team provides immediate assessment and treatment, employing various techniques from medication to surgical interventions based on the type and duration of priapism.

Immediate Treatment Candidates

• Any man experiencing an erection lasting more than 4 hours
• Patients with painful erections unrelated to sexual arousal
• Individuals with known risk factors experiencing prolonged erections
• Men with sickle cell disease experiencing recurrent episodes
• Patients who have used erectile dysfunction medications and experience prolonged erections
• Those with penile trauma resulting in persistent erection

Risk Factors Requiring Monitoring

• Sickle cell disease or trait
• Leukaemia or other blood disorders
• Use of certain medications (antidepressants, blood thinners, recreational drugs)
• Previous episodes of priapism
• Penile injections for erectile dysfunction
• Spinal cord injuries

Any man experiencing an erection lasting more than four hours should seek immediate medical attention, regardless of pain level. Our urologists conduct rapid assessments to determine the type of priapism and initiate appropriate treatment promptly.

Aspiration and Irrigation

This first-line treatment for ischaemic priapism involves numbing the penis with local anaesthetic before inserting a needle to drain trapped blood. The urologist then flushes the penis with saline solution to remove old blood and restore normal circulation. This technique is effective when performed within 4-6 hours of onset.

Medication Injection (Intracavernosal Sympathomimetics)

Following aspiration, medications such as phenylephrine may be injected directly into the penis to constrict blood vessels and promote drainage. These alpha-adrenergic agonists help restore normal blood flow patterns. Multiple injections may be necessary, with careful monitoring of blood pressure and heart rate.

Surgical Shunting Procedures

When conservative measures fail, surgical creation of a shunt between the corpus cavernosum and corpus spongiosum or glans penis allows trapped blood to drain. Various shunting techniques exist, from percutaneous procedures to open surgical approaches, selected based on individual circumstances.

Conservative Management for Non-ischaemic Priapism

High-flow priapism often resolves spontaneously and may initially be managed with observation, ice packs, and pressure. If persistent, selective arterial embolisation can block the abnormal blood flow while preserving normal erectile function.

Pre-Treatment Assessment

Upon arrival, immediate evaluation includes taking a detailed history of symptom onset, associated pain, potential triggers, and any medications used. Physical examination assesses penile rigidity and tenderness. Blood tests from the penis (blood gas analysis) help differentiate between ischaemic and non-ischaemic priapism. Doppler ultrasound may be performed to evaluate blood flow patterns.

During the Procedure

For aspiration and irrigation, local anaesthetic is administered to minimise discomfort. Using sterile technique, the urologist inserts a needle into the corpus cavernosum to aspirate blood. Dark, deoxygenated blood typically indicates ischaemic priapism. Saline irrigation follows until bright red blood returns. If needed, sympathomimetic medications are injected at 5-10 minute intervals while monitoring vital signs. The entire process typically takes 30-60 minutes.

Immediate Post-Treatment

Following successful treatment, patients are monitored for 30-60 minutes to ensure detumescence (softening) is maintained. Pain relief medication is provided as needed. The urologist explains warning signs of recurrence and provides emergency contact information. Most patients can return home the same day with clear follow-up instructions. A compression dressing may be applied to minimise swelling.

First 24-48 Hours

Patients should rest and avoid strenuous activities. Ice packs applied for 10-15 minutes every few hours help reduce swelling and discomfort. Pain medication should be taken as prescribed. Sexual activity should be avoided until cleared by the urologist. Any signs of recurrence require immediate medical attention. Bruising and mild swelling at injection sites are normal.

First Week

Follow-up appointment within 2-3 days allows assessment of treatment success and erectile function. Gradual return to normal activities is encouraged. Patients should monitor for any unusual symptoms or changes in urination. Those with underlying conditions like sickle cell disease may require additional monitoring. Psychological support may be beneficial for anxiety related to the episode.

Long-term Recovery

Complete healing typically occurs within 2-4 weeks. Erectile function testing may be performed after one month to assess any impact. Patients with recurrent priapism may need preventive treatments or medication adjustments. Regular follow-up helps identify and manage any complications. Lifestyle modifications to address underlying risk factors are discussed.

Prompt priapism treatment offers significant benefits for both immediate relief and long-term sexual health. Early intervention dramatically reduces the risk of permanent damage to penile tissue. Treatment provides immediate pain relief, ending what can be an excruciating experience for patients.

Successful treatment prevents psychological trauma associated with prolonged priapism. Many men experience significant anxiety during episodes, and effective treatment provides reassurance and confidence. For those with recurrent priapism, establishing a treatment plan offers peace of mind and rapid access to care when needed.

Treatment also identifies underlying causes, allowing management of conditions that may trigger future episodes. This comprehensive approach reduces recurrence risk and improves overall urological health. Patients gain understanding of their condition and warning signs, empowering them to seek timely care if symptoms return.

Common Side Effects

Bruising and tenderness at injection sites typically resolve within days. Mild swelling of the penis is expected after treatment. Temporary changes in skin colour may occur but fade gradually. Some patients experience lightheadedness from medications, which resolves quickly with monitoring. Minor bleeding at needle insertion points stops with gentle pressure.

Rare Complications

Despite proper technique, some patients may develop erectile dysfunction, particularly with delayed treatment. Infection at injection sites, though uncommon with sterile technique, requires antibiotic treatment. Rarely, patients may experience allergic reactions to injected medications. Penile fibrosis can develop in cases of recurrent priapism or multiple treatments.

Our experienced urologists minimise these risks through careful technique, appropriate medication dosing, and close monitoring. Early treatment remains the most important factor in preventing complications. Regular follow-up allows early detection and management of any developing issues.

Priapism treatment costs vary based on the urgency of presentation, type of priapism, and specific interventions required. Emergency department visits typically incur additional charges compared to direct specialist consultation. The cost includes initial assessment, diagnostic tests, the procedure itself, medications, and immediate follow-up care.

Factors affecting total cost include the need for ultrasound imaging, blood tests, complexity of treatment required, and whether surgical intervention becomes necessary. Some patients require multiple treatment sessions or long-term preventive therapy, impacting overall expenses. Hospital admission, though rarely needed, would incur additional charges.

We provide transparent cost estimates during consultation, helping patients understand their financial commitment. Our clinic offers various payment options to ensure timely access to this critical emergency treatment.