Question on damage from Priapism

[donnyblue]

Regarding Priapism: They say that Priapism is an erection lasting longer than 4 hours. And permanent damage can occur after 4 hours that would result in future erectile dysfunction.  My question is what type of erection qualifies for the 4 hours duration? For example sometimes I wake up with a full erection, then go the the bathroom. When I get back to my bed, I notice that my penis is about 30% to 40% erect, but not fully erect.  It stays this way for awhile and I wait until it goes flaccid, but sometimes I wait for awhile then just go back to bed with it 30% erect.  I'm wondering if my penis is only 30% erect for many hours does this qualify as time towards that 4 hours? Again, I go back to bed during this time that my penis is 30% erect and I wonder if, while I'm sleeping and it were to stay in that 30% erect state for many hours, could it begin to get permanently damaged?  or does it have to fully erect, 100% for 4 hours or more for this damage to begin?

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I can understand your concern for priapism.

When a man gets aroused, blood vessels widen to let more blood flow into the penis. As the penis fills with blood, it becomes hard and erect. After the man has an orgasm or the stimulation ends, the blood flows back out of the penis which makes it soften again. In priapism the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. However this erection is not 30% but is complete 100% erection. It may be painful or painless.

You should not worry as what you are having is nocturnal penile tumescence which is a spontaneous erection of the penis during sleep or when waking up. In lay man terms it is called morning erections. It is physiological and normal and a normal man can have it usually three to five times during the night, typically during REM sleep and these can last for 30 minutes each.  The penis may stay erect for up to two hours nightly also. In fact NPT test ( nocturnal penile tumescence test) is used for finding out if erectile dysfunction is psychological or pathological in a patient.

Hope that this information helps and hope that it has relieved you of your doubts.

Wishing you good health.

[donnyblue]

Thank you Dr. Kaur.  May I ask a clarification question?  
I understand that nocturnal penile erection are normal.
I also understand that the damage will occur if the penis is 100% erect for over 4 hours (priapism). My question is....
Are you saying that if my penis is only semi-erect (for example at 30% to 50% of a full erection) for over 4 hours this will NOT cause permanent damage to the penis and tissue?
Thank you!