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Priapism Adapted for African Communities

Author's details

  • Hakim A Abubakre
  • BA (Hons) International Business Management, Msc Digital Marketing.

Reviewer's details

  • Dr Taofiq Mohammed
  • MBBS (Ilorin), ChM (Edinburgh), MRCSEd, FWACS(Urology).
  •  Formerly, Consultant Urologist, University of Ilorin Teaching Hospital, Ilorin, Nigeria. Senior Clinical Fellow in Urology  University Hospital Coventry and Warwickshire, Coventry, United Kingdom. 
  • Date Published: 2025-05-05
  • Date Updated: 2025-05-05

Priapism Adapted for African Communities

Introduction

What is Priapism?

Priapism is a condition where a man experiences an ongoing erection lasting more than four hours, without sexual stimulation. It is often painful and occurs when blood becomes trapped in the penis and cannot drain properly.

Priapism happens because of a failure in the body’s normal mechanisms that regulate the penis becoming hard (tumescence), staying erect (rigidity), and becoming soft again (flaccidity). Without treatment, it can cause permanent tissue damage and lead to erectile dysfunction (inability to get or maintain an erection).

It is a medical emergency, if not treated quickly, it may cause long-term harm.

 

Discussion

Who Can Get Priapism?

While priapism is not common, it affects certain groups more frequently:

  • Men and boys with sickle cell disease – a leading cause in Africa
  • People with blood cancers such as leukemia
  • Those with malaria, especially cerebral malaria
  • Men using traditional aphrodisiacs or unregulated sexual enhancers
  • Those abusing alcohol or recreational drugs
  • People with spinal cord injury or trauma to the penis
  • Men taking certain prescription drugs (e.g., for mental health or erectile dysfunction)

Although it often affects men in their 30s or older, it can begin in younger boys with sickle cell disease.

Types of Priapism

Type Description
Ischemic (low flow) The most common and dangerous type. Blood becomes trapped in the penis. It is very painful and requires urgent treatment.
Non-ischemic (high flow) Less common. Caused by injury or abnormal blood flow. It is usually not painful and less urgent.
Stuttering priapism Recurrent short episodes that start and stop over time. Often seen in men with sickle cell disease.

Each type requires different treatment, so it’s important to see a health worker for the correct diagnosis.

Signs and Symptoms

  • Erection lasting more than four hours, unrelated to sexual desire
  • Pain in the penis
  • Penis may be hard in the shaft but soft at the tip
  • Repeated, short-lived erections (in stuttering priapism)

Why Is This Serious?

If blood is trapped in the penis for too long, it doesn’t get enough oxygen. This can lead to permanent damage to the penile tissue, and loss of sexual function. That’s why any erection lasting longer than four hours must be treated immediately.

Seek help immediately from a qualified medical practitioner if you have sustained erection lasting beyond 2-4 hours. This is a medical emergency, and  Self-help may delay timely intervention. 

When to Seek Medical Attention Immediately

  • If you have an erection lasting longer than 4 hours
  • If you have sickle cell disease and get an erection that lasts longer than 1 hour or is painful
  • If you get frequent or repeated erections not related to sexual activity
  • If you cannot urinate or feel discomfort in the genital area

Prevention Tips

  • Manage underlying conditions like sickle cell disease, malaria, or blood disorders
  • Avoid recreational or herbal sexual enhancers, especially those not approved by health authorities
  • Only take medication as prescribed
  • Wear protective gear during sports or heavy physical activity to prevent injury
  • Avoid alcohol and illegal drug use

For people with sickle cell disease, your doctor may recommend medications to reduce the risk of stuttering priapism.

Key Messages

  • Priapism is rare but serious
  • It is more common in African communities because of sickle cell disease and malaria
  • Quick medical care can prevent complications
  • Avoid unregulated drugs or aphrodisiacs
  • Don’t be shy—seek help early if you or your child shows symptoms
References
  1. Broderick, G.A., Kadioglu, A., Bivalacqua, T.J., Ghanem, H., Nehra, A. and Shamloul, R., 2010. Priapism: pathogenesis, epidemiology, and management. The journal of sexual medicine, 7(1_Part_2), pp.476-500.
  2. Emond AM, Holman R, Hayes RJ, Serjeant GR. Priapism and Impotence in Homozygous Sickle Cell Disease. Arch Intern Med. 1980.
  3. Adeyoju A, Olujohungbe A, Morris J, et al. Priapism in Sickle Cell Disease: Incidence, Risk Factors and Complications. Br J Haematol. 2002.
  4. World Health Organization (WHO). Sickle Cell Anaemia: Report by the Secretariat. 2006. https://www.who.int
  5. NHS UK. Priapism – Overview. https://www.nhs.uk/conditions/priapism