semi erect due to injury

[kenwood72]

about 2 weeks ago I crashed on a bike and my penis hit the seat.  it hurt at first and there was a little pain, like a bruise, for a week or so but nothing was outwardly noticeable.

Then about a week later my penis became semi erect and will not go down or upp fully.

I went to the doctor and he said there is NOTHING that can be done.  

I am experincing discomfort and I believe it is from everything being kinda jammed together now.

I can urinated and ejaculate without pain for problem but being semi erect is my major issue.  

Can you offer any guidance?

[Dr Smitha Mathews]

Hi,
Semi erection followin trauma is also known as high-flow priapism.

Did your doctor also mention how long it would take for the injury to resolve?

"# High-flow priapism is uncommon
# Due to  the development of an arteriocavernosal fistula
# Can follow blunt or penetrating penile or perineal trauma"

"# High-flow priapism is often painless
# There is invariably a clear history of trauma"

"# Aspiration of the corpora will distinguish the two types
# In high-flow priapism the blood is arterial"

"Early treatment is essential, preferably within 12 hours of onset"
"# Detumescence can be achieved in 50-70% of patients
# Maintenance of erectile function is present in about 40%
# High-flow priapism requires closure of the arteriocavernosal fistula
# Can often be performed by an interventional radiologist"

http://www.surgical-tutor.org.uk/default-home.htm?system/urinary/priapism.htm~right

You will need to seek help in surgical management of this condition at the earliest, given its potential for lasting penile function impairment.

Do keep us posted on your odubts and progress.
Regards

[kenwood72]

the doctor told me to wait at least a month to see what happens.  he said I could end up like this for good and that i would just leave it as is.

i am very worried now to say the least.  there has never been and bruising or bleeding.

[Dr Smitha Mathews]

Hi,

The type of priapism decides the intervention.
Any injury to the penis or other highly vascular structures that can cause impaired blood circulation can cause nerve damage and cause lasting damage, without intervention at the right time.

It all depends on which part of the penis has been injured and whether arterial or venous blood supply has been impaired.

Do get a second opinion.

You need attention by a urologist.

Regards

[kenwood72]

i think i need to see another urologist and the person I went to was supposedly a good one.  he did a thorough exam and said he found nothing but there was no scans or anything like that done.  he told me to go back to normal and just wait.

i think his feeling was that to operate would be more risky that worthwhile.  I am so upset right now as I feel something should have been done immediatley and now I am over 2 weeks from the onset.

[Dr Smitha Mathews]

Hi,

It may not be too late to manage the problem.

Just seek a second opinion and explore possibilities of closing the arteriocavernosal fistula (if there has been one).

Other treatment approaches can be explored once you have had an examination by another urologist and radiological imaging to identify the extent of the problem.

Do post any further doubts you may have.

Regards

[kenwood72]

thinking back he told me i did not have priapism, which seems odd since in all the reading i have done that would be the diagnosis.  it is a holiday here and I cant get the though out of my head that my function may not come back.

[Dr Smitha Mathews]

Hi,

It is possible that your organ is healing in this period and the body will mediate healing by releasing enzymes and cells that help breakdown the collection of blood.

The delay has happened and cannot be reversed so it will be ineffectual to worry about it.

But you can focus on the avenues you will explore for further management so that you will be able to deal with this efficiently.

Do post for any help you need in this regard.
Regards

[kenwood72]

further management? is there truly any other diagnosis?  i knowit is tough to say but was my doctor wrong?

[Dr Smitha Mathews]

Hi,

A doppler study of the penis would give an idea about blood supply and the cause of the semierection.

Once the cause has been identified, it can be corrected, or at least improved.

If the cause is an arteriocavernosal fistula (the probable cause), it can be repaired.

Regarding your doctor's advice - you need to have a second opinion and a detailed examination supported by radiological imaging, before you can say anything conclusively.

Regards