Key takeaways:
Priapism is an erection lasting over 4 hours that isn’t related to sexual arousal.
It can be caused by certain medical conditions, medications, drug use, or trauma to the penis.
Priapism is a medical emergency that needs prompt medical care.
An erection that won’t go away can be alarming. And, in some cases, it can become a medical emergency. Most erections resolve on their own. But a persistent erection can sometimes signal a condition known as priapism, which needs urgent treatment.
Here, we’ll review what causes priapism to happen, how it’s treated, and when to seek emergency care.
What is priapism?
Priapism is a prolonged erection that won’t go away on its own. It’s defined as an erection lasting more than 4 hours and not related to sexual activity.
What are the types of priapism?
An erection happens when the penis fills with blood. In priapism, blood flow doesn't return to normal, causing the erection to persist. The main difference between types of priapism is what causes too much blood to accumulate in the penis.
Low-flow (ischemic) priapism
With low-flow (ischemic) priapism, the erectile tissues in the penis fill with blood, which then can’t drain properly. This causes blood to get trapped in the penis.
This is the most common and most serious type of priapism. It usually causes a painful, rigid erection and requires emergency treatment to prevent damage.
Recurrent (stuttering) priapism
Sometimes, low-flow priapism can happen repeatedly. Recurrent — or stuttering — priapism is a type of low-flow priapism. It causes repeated episodes of prolonged, often painful erections. The episodes may go away on their own at first. But they can become more frequent or severe over time.
High-flow (non-ischemic) priapism
This typically happens as a result of an injury involving the penis, pelvis, or groin. A lot of blood flows into the erectile tissues in a short space of time, but it eventually drains out as normal.
This type of priapism is usually not painful and is less likely to cause tissue damage.
What causes priapism?
Common causes of priapism include:
Blood disorders, such as sickle cell disease and leukemia
Certain medications, including antidepressants, blood pressure medications, blood thinners, and erectile dysfunction (ED) medications
Alcohol use
Recreational drugs, such as cocaine and cannabis
Injury to the penis or pelvis
In some cases, no clear cause is identified.
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What are the symptoms of priapism?
The main symptom of priapism is an erection that lasts longer than 4 hours and doesn’t go away on its own.
Other symptoms may include:
Increasing pain in the penis
A persistent erection without sexual arousal
Repeated episodes of prolonged erections
How is priapism treated?
Treatment of priapism depends on the type you’re experiencing.
Low-flow (ischemic) priapism treatment
Low-flow (ischemic) priapism requires emergency treatment in a hospital or emergency department. Treatment may include:
Aspiration: A small needle is used to drain blood from the penis to relieve pressure.
Medication injection: A medication such as phenylephrine is injected into the penis to restore normal blood flow.
Shunt: If other treatments don’t work, a urologist may create a small opening to allow blood to drain.
Recurrent priapism treatment
Recurrent priapism may be treated with the same therapies during episodes. Long-term treatment may also involve medications or preventive therapies to reduce recurrence.
High-flow (non-ischemic) priapism treatment
High-flow (non-ischemic) priapism may go away on its own. Treatment options include:
Observation: Since many cases resolve without treatment, your healthcare team may recommend monitoring closely.
Selective arterial embolization: This is a procedure in which a healthcare professional performs a small surgical procedure to block the injured blood vessel that’s causing excess blood flow into the penis.
When should I seek medical care?
Priapism is always a medical emergency. Timely treatment also prevents long-term damage to the penis.
Seek emergency care right away if you have:
An erection lasting more than 4 hours
A painful erection
An erection that doesn’t go away after sexual activity ends.
Most people will need evaluation in an emergency department. While it may feel uncomfortable or embarrassing, treatment shouldn’t be delayed.
What happens if I don’t get priapism treated?
Without treatment, blood trapped in the penis can lose oxygen over time. This can damage the tissue inside the penis and lead to scarring. In severe cases, this may result in long-term or permanent ED. This is why getting emergency medical care is important.
Will priapism go away on its own?
Non-ischemic priapism, the less serious kind, is more likely to resolve on its own than ischemic priapism. But it can be tricky to tell the difference, so it’s best not to wait to find out, especially given the risks.
Frequently asked questions
Yes, priapism can often be treated successfully, especially when it’s treated quickly. In many cases, treatment restores normal blood flow and the erection goes away. The key is getting medical care right away to reduce the risk of long-term complications.
No, ejaculating won’t relieve priapism. Priapism happens because blood is trapped in the penis, not due to sexual arousal. So it doesn’t go away with orgasm or sexual activity.
No, Viagra (sildenafil) doesn’t treat priapism. In rare cases, it can actually trigger priapism.
Yes, priapism can often be treated successfully, especially when it’s treated quickly. In many cases, treatment restores normal blood flow and the erection goes away. The key is getting medical care right away to reduce the risk of long-term complications.
No, ejaculating won’t relieve priapism. Priapism happens because blood is trapped in the penis, not due to sexual arousal. So it doesn’t go away with orgasm or sexual activity.
No, Viagra (sildenafil) doesn’t treat priapism. In rare cases, it can actually trigger priapism.
The bottom line
Priapism is a condition in which an erection lasts more than 4 hours. There are many different causes of priapism, including erectile dysfunction (ED) medications and sickle cell disease. Priapism can lead to permanent damage to the penis, so it’s important to get help fast. There are quick and effective treatments available, and emergency medicine and urology specialists can provide them.
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References
Borrell, J. A., et al. (2025). Risk factors, diagnosis, and long-term erectile dysfunction outcomes in priapism: A retrospective analysis of 186 cases from a single institution. International Journal of Impotence Research.
Fernandez Crespo, R. E., et al. (2024). Penile fibrosis-still scarring urologists today: A narrative review. Translational Andrology and Urology.
National Health Service. (2023). Priapism (painful erections).
Scherzer, N. D., et al. (2019). Unintended consequences: A review of pharmacologically-induced priapism. Sexual Medicine Reviews.
Shigehara, K., et al. (2016). Clinical management of priapism: A review. The World Journal of Men's Health.
Silberman, M., et al. (2025). Priapism. StatPearls.
