Why does priapism occur?

Generally, penile erection occurs in men upon sexual stimulation. However, many men experience spontaneous (non-stimulated) penile erections. So, what causes priapism—abnormal, persistent penile erection?

What Causes Priapism?

Priapism is a pathological condition—not a normal physiological response—and refers to a prolonged, painful erection unrelated to sexual desire or stimulation. It is commonly associated with underlying medical conditions or drug misuse. Clinically, it frequently occurs in patients with leukemia, thrombocytopenia, or spinal cord injury. Additionally, excessive use of erectile-enhancing medications—such as overdosing on sildenafil (Viagra®) or tadalafil (Cialis®), or consuming unregulated, illicit sexual health supplements—may also trigger priapism.

During an episode of priapism, the penis becomes severely engorged and congested, often appearing bluish-purple, accompanied by significant pain. The penile shaft becomes rigid and loses its normal elasticity. Without prompt treatment, this condition can impair future penile function. Initial conservative management may include sedatives, analgesics, and localized application of ice packs. If these measures fail to resolve the condition, immediate referral to a tertiary-level hospital for urological evaluation and intervention—such as corporal aspiration and irrigation, or surgical shunt procedures (e.g., distal shunt between the corpus cavernosum and glans penis)—is strongly recommended. Such interventions rapidly decompress the trapped blood within the corpora cavernosa, thereby preventing irreversible damage to the cavernosal tissue and subsequent organic erectile dysfunction.

Once abnormal erection occurs, timely and effective treatment is essential. Delay or inadequate management increases the risk of complications and compromises quality of life. We hope this information proves helpful to you!