kidney and urinary tract disorders
Persistent Erection
Evaluation of a Persistent Erection
The following information can help people know when to see a doctor and what to expect during the evaluation. In boys and men with priapism, certain symptoms and characteristics are cause for concern. They include Severe pain Age less than 10 years Recent injury to the penis or groin area Fever and night sweats All boys and men who have priapism should see a doctor immediately for treatment. If warning signs are present, further evaluation may be necessary to determine whether the cause of priapism is something unusual or serious. Doctors first ask questions about symptoms and medical history and then do a physical examination. What they find during the history and physical examination often suggests a cause of priapism and the tests that may need to be done (see table Some Causes and Features of Priapism ). Doctors ask How long the erection has been present Whether there is pain Whether there has been an injury to the penis or the groin area Whether conditions (such as Sickle Cell Disease ) that may cause priapism are present What drugs have been taken, including drugs for erectile dysfunction and recreational drugs Although doctors focus the physical examination on the genitals to detect signs of injury or cancer, they also examine the abdomen and do a digital rectal examination. Doctors may also do a neurologic examination to look for signs of a spinal cord disorder. The need for testing depends on what doctors find during the history and physical examination. Often, the type of priapism (ischemic or nonischemic) and cause are obvious, such as the use of a drug to treat Erectile Dysfunction (ED) . If it is not clear whether priapism is ischemic or nonischemic, doctors may take a sample of blood from the penis to test for the presence of oxygen and other gases (arterial blood gas measurement). They may also do duplex ultrasonography (ultrasonography that measures blood flow and shows structure of the blood vessels through which the blood is flowing). These tests help differentiate ischemic from nonischemic priapism. Ultrasonography may also show the blood flow patterns in priapism and the anatomic abnormalities contributing to priapism. If the cause is still not obvious, doctors test for blood disorders and A complete blood count Urinalysis and Urine Culture and Sometimes hemoglobin electrophoresis, particularly in boys and men of African or Mediterranean descent Hemoglobin electrophoresis is a blood test to check for abnormal hemoglobin (the protein that carries oxygen in red blood cells) as occurs in sickle cell disease. Because some boys and men may be embarrassed to admit they have used recreational drugs, doctors sometimes do drug screening. Occasionally, Magnetic resonance imaging (MRI) or 