PRIAPISM as cause?

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Hadmad

Hello, I would like to ask some opinions of the members since doctors and urologists have been absolutely no help for me and seems that no one in the world can give any answers. I would gladly appreciate your contribution and opinions.

I was diagnosed Peyronie's not long ago. I'm 24 and I believe my initial onset was caused by a prolonged erection. At least the pains started about week after that. I have other problems as well that started maybe week after this injury:

My first question is: Since priapism can cause fibrosis: HOW DOES PEYRONIE'S DISEASE AND PENILE FIBROSIS DIFFER? IS IT THE SAME THING?

The second thing that bothers me: that I have prolonged erections EVERY NIGHT
I have found some people on the internet like this post that describe my symptoms:
Link deleted to a commercial site - James.
Please obey the forum rules


Basically, as fast I fall sleep my penis stays in semi-rigid state throughout the night and nocturnal erections wake me up several times a night.

THIS IS NOT NORMAL NOCTURNAL PENILE TUMESCENCE. I've had nocturnal erections since my puberty: they have never existed for hours and hours at end. I believe my penis stays in semi-rigid state erect even as long as 5-6 hours a night: depending how many times a wake up. Those erections WON'T GO DOWN unless I stand up and walk for few minutes. These are not normal nocturnal erection episodes that would last 15-20mins in a normal person: the penis is stuck in a semi-rigid state for hours at end. Sometimes the erection is 'triggered' by full bladder, this I remember was quite normal when I was younger too, but the erections are now more rigid, sometimes painful, and stay in semi-erect state.

I had symptoms like soft glans and hourglassing few months ago, the hourglassing has improved in a sense that the indentation is now visible only on the other side, the dent on other side disappeared. So I have a thing like HALF-HOURGlass at the moment and my glans is not soft anymore, the glans is filling up considerably at the moment. Not much changes in curvature, it is still bad curving to left and the head dorsally curving towards me. all the palpable plaque appears just right under glans, where my circumcision scar is located

I have not had pain in flaccid state, the only pain present is when I am having these nocturnal erections episodes or if I press the scar tissue very hard. Penis does not feel 'inflamed' in flaccid state.

I am absolutely devastated at the moment. Some people say the erections are good thing, while I myself FEEL that those prolonged erections are causing me fibrosis. I don't even know what supplements should I  take at the moment because it feels like as if my blood flow is too good. I'm really lost..


james1947

Partially answer:
Peyronies plaques are fibrosis, so long erections causes Peyronies.
Erections lasting 4 or more hours should be treated immediately.
If you have prolonged erections every night, you should go to ER immediately.
While diagnosed with Peyronies, you told the doctor that you have those prolonged erections?
He should know how to treat this situation.
What is the treatment you are making for Peyronies?

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Pfract

"I believe my penis stays in semi-rigid state erect even as long as 5-6 hours a night: depending how many times a wake up. "

You believe, as in... you are sure because you are looking at it staying erect due to insomnia, or you think that it stays up but are not sure? it makes a huge difference to your situation this precise point.

"Those erections WON'T GO DOWN unless I stand up and walk for few minutes. These are not normal nocturnal erection episodes that would last 15-20mins in a normal person: the penis is stuck in a semi-rigid state for hours at end. Sometimes the erection is 'triggered' by full bladder, this I remember was quite normal when I was younger too, but the erections are now more rigid, sometimes painful, and stay in semi-erect state.""

There are two types of priapism. Veno-occlusiv, and arterial priapism. Bought very different in treatment and in consequences to your penis. I cannot street this enough, but a priapism is a rare thing, and can be triggered but trauma to your penis, depression medications, blood disorders (sickle cell anemia...) drugs (cocain, alprostadil...) but should not be left without medical treatment. Also, if your erections last for more than 5/6 hours, you start damaging your penis real bad, in terms of ischemia and consequential fibrosis and other things.

The Management of Stuttering Priapism

"the management of stuttering priapism

I explained that each episode of ischemic priapism in these patients should be managed as an emergency. I als"o explained that etiology of the recurrent ischemic priapism is often idiopathic, patients with hematologic abnormalities, such as sickle cell disease, are more prone to developing recurrent (stuttering) priapism.

I explained that several studies have shown that early management at home by the patient with intracavernosal injection of sympathomimetics can be an effective strategy to avoid hospitalization for patients with recurrent priapism. Patients who cannot be treated with hormonal therapy may be taught self-injection therapy of sympathomimetics.

I explained that hormonal therapy for stuttering priapism works by suppressing serum testosterone levels by feedback inhibition (diethylstilbestrol), blocking androgen receptors (antiandrogens) and down-regulation of the pituitary gland (GnRH agonists). I also explained that hormonal agents, specifically GnRH agonists, appear to be effective and while they reduce libido, most patients are still able to engage in sexual activity. Hormonal agents have a contraceptive effect and interfere with normal sexual maturation. In addition, they may interfere with the timing of the closure of the epiphyseal plates. Therefore, these agents are contraindicated in children who have not completed their growth and sexual maturation and those trying to conceive.

There has also been reports of sildenafil use in stuttering priapism. A small case series showed that daily sildenafil or tadalafil therapy reduced ischemic priapism episodes in men with stuttering priapism. Also in another study when used in long-term dosing regimen unassociated with erection stimulatory conditions, PDE5 inhibitor therapy alleviates recurrent priapism episodes in men with sickle cell disease-associated priapism and idiopathic priapism without affecting normal erectile capacity. According to these studies, a trial of daily oral PDE5 inhibitor therapy may be used in the management of patients (adults and children) with stuttering ischemic priapism associated with hemoglobinopathies. Dosing should be initiated under conditions of complete penile flaccidity. Dosing efficacy should be monitored for frequency and severity of stuttering episodes, and PDE5 inhibitor side effects and normal erectile capacity.

Two cases of stuttering priapism have been successfully treated with oral baclofen in the literature.

The patient understood these treatment options and agreed to (insert treatment)
therapy for management of his stuttering priapism. He will be given a prescription for (phenylephrine 100 mcg/100ml normal saline, GnRH agonist, antiandrogen, baclofen, PDE5 inhibitor) and will return to clinic in 1 month to determine efficacy."

This comes from a doctor. good luck.

KAC

I experienced something similar when I was taking Arginine.  It seemed like nocturnal erections would last until I got out of bed and walked around.  Then it subsided immediately.  It really distressed me for a while. People on this website told me not to worry about it, so I stopped.  I also quite taking the arginine and that seemed to stop it. I don't think any damage was done--I wonder if a semi-rigid erection allows for ongoing blood flow in a way that priapism does not.

james1947

You are right KAC, semi-rigid erection is not Priapism.
I misses the "semi rigid" in the topic opening post.

James  
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Alvoip

I get the same thing, mine are uncomfortable though. I'm 29.

I don't know if they are truly erect for the entire night because I rare get them within 20-45 minutes of falling asleep that feel like they have been stuck for hours too. Sometimes I will wake up with a massively engorged erection, I have to get up and walk off (high pressure feeling, skin feels tight/glossy/transparent/rubbery smooth with visible veins - usually quite straight though, can feel numb or painful too).

I also commonly wake up a billion times a night with uncomfortable partial erections (this really drains you, some nights I don't even want to sleep due to the anxiety and discomfort), bladder being full does worsen things (so does very high libido/arousal if abstaining which I personally do due to massive swollen and tender veins or lymph channel swellings limiting me to once a week).

I also get uncontrollable penis spasms (it rapidly spasms inwards towards my body) if the glans touches the sheets in certain positions which can cause them.  I was diagnosed in early 2013 as having Peyroine's by a urologist (who said he couldn't FULLY diagnose it because there was no palpable plaques on exam - It still hasn't stabilized 26+ months later). I have moderate hour glassing, a downward/left bend of varying degrees depending on erection strength (commonly 70+ degrees downward starting, they did fill in quite well but are starting to lose that ability and having some quite noticeable ED).


My grandfather does have a contracture of his pinky and ring finger on one hand.

I don't know about your masturbation habits but when I was at a low point in my life preceding my diagnosis I would edge to porn for hours (at my lowest 8+ hour sessions, multiple times a week - mostly mental arousal / browsing but lots of hands on too). If this sounds familiar then I'd try and increase frequency over duration assuming you don't get swelling like I do and keep libido/anxiety low.

It's a long shot but if you are browsing porn for more than an hour or so or are constantly aroused then I'd try and dial it down in duration.


Who diagnosed your peyroine's (GP, uro, andro)? did they confirm what you are feeling are plaques and not other types of lumps or swellings?  

Was this "initial prolonged erection" caused by something in particular? (long masturbation, injury, etc?)

I wouldn't drink for 3+ hours before bed and if it continues consider an ultrasound like I am.

rjl88

iv been getting this for years even pre peyronie i havent slept good for years cause of it it went away for a few monthsnot too long after that i got my first sign of peyronies then it came back again later in my peyronies.

Lemten

(Disclaimer: I haven't been diagnosed with Peyronie's, but there has been some kind of a fibrotic change running through the middle of my penis, accompanied by erectile dysfunction for 11 years)

My problems started after a drunken night of sex. I don't recall any sense of an injury during the act itself, but who knows. Anyway, the act lasted for pretty long but I wasn't able to ejaculate. So, finally I fell asleep with my penis erected and the condom still on. Of course, when drunk, I guess it would be expected for the erection to subside easier. But I'm just wondering whether my penis was in a sort of a hyperaroused state (due to not ejaculating) and stayed erected throughout hours during the night, added to the condom which might have had sort of a strangulating effect (like a cock ring) -- resulting in some kind of a priapism?

All I know is that the next day I noticed my hard flaccid along with the induration running through the smooth tissues. And morning erections stopped etc. etc. (more detailed in my introductory post)

So, let's say it was the prolonged erection that caused all this. What would be the mechanism? Hypoxia? What kind of a fibrosis would this be? Could it be treated with Xiaflex just the same as Peyronie plaques?
30 yo /Symptoms since: 19 yo / Erectile dysfunction; lack of morning erections, arousal-induced erections go away almost immediately, hardenened tissue running longitudinally "between" the corporal tissues (septally?), shortening, hard flaccid

Twilli81

I too suffer from the same thing as you guys. Ive had Peyronies for like 15 years (Im 41 now) and I remember having this for about a year when I first noticed I had Peyronies. Then it somehow got better (not Peyronies itself just the nighttime painful erections thing) for years, but the last 6 months to year its come back with a vengence. I think I injured it again having drunk sex with my wife. Anyway, now its unbearable, pain like every night that wakes me up. And, like others have said, seems to be worse when I have to pee.  
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