Sexually transmitted diseases Reviewed by Dr David Delvin, GP and psychosexual expert
Unfortunately, in 2010 sexually transmitted diseases (STDs) have become very common. This is undoubtedly because more and more people are having enjoyable, but sometimes risky, sex lives – often with several partners.
What sort of diseases are we talking about? Below you'll find a number of conditions that are currently being seen by NHS genitourinary medicine (GUM) clinics in the UK.
Please bear in mind that some of them (most notably thrush) may not have been acquired through sex.
Chlamydia Chlamydia is the most common and fastest spreading sexually transmitted disease in the UK. It stems from a bacterium, Chlamydia trachomatis.
Women diagnosed with chlamydia can also infect their newborn infant during delivery. Symptoms usually appear approximately 7 to 21 days after infection and differ for men, women and children.
Gonorrhoea Gonorrhoea is caused by Neisseria gonorrhoeae, a bacteria that grows and multiplies quickly in moist, warm areas of the body – such as the cervix, urethra, mouth, or rectum. The cervix is the most common site of infection in women.
However, the disease can also spread to the uterus (womb) and fallopian tubes, causing pelvic inflammatory disease leading to infertility.
Gonorrhoea is most commonly spread during genital contact, but it can also be passed from the genitals of one partner to the throat of the other during oral sex. Gonorrhoea of the rectum can occur in people who practice anal sex. In pregnant women, gonorrhoea can be passed from an infected woman to her newborn infant during delivery if left untreated.
Genital herpes Gential herpes is a highly contagious viral condition caused by the herpes simplex virus (HSV).
It infects the skin and mucous membranes of the genitals and rectum, but it can also appear in areas such as the mouth.
It's transmitted primarily through physical and sexual contact. During birth, the presence of herpes simplex virus on the genitalia or in the birth canal is a threat to the infant.
HIV and AIDS AIDS is a potentially lethal sexually transmitted disease and is caused by the HIV virus. HIV means 'human immunodeficiency virus'.
HIV invades and destroys the immune system, which protects the body from infection. This means that a person who carries the HIV virus is prone to many different illnesses and may die from diseases that are harmless to healthy people.
In some countries, particularly those located in Sub-Saharan Africa, the HIV rates are very high. For instance, in the Republic of South Africa it's estimated that about 11 per cent of the population is HIV-positive.
Genital warts Warts, or condylomata acuminata, are caused by the human papilloma virus (HPV).
Up to nine months can pass from the time of infection to the actual development of warts.
In women, HPV can lead to changes in the cervix and to the development of cervical cancer. Therefore, it's important that this condition is diagnosed and treated.
Syphilis Syphilis is a dangerous and life-threatening bacterial disease. It's passed on by intercourse, or by almost any other form of sexual interaction.
The first signs appear between 9 and 90 days after exposure to the germ that causes it.
After infection, the bacteria is transported through the body via the bloodstream and adversely affects vital organs such as the heart, brain, nervous system and spine.
Trichomonas Trichomonas vaginalis (often known as 'TV') is a protozoan 'bug' that used to be a common cause of vaginal discharge and intense vulval soreness.
Bacterial vaginosis The diagnosis of bacterial vaginosis (BV) has become common during the last 10 years, with about 95,000 women per year being seen in GUM clinics, and an unknown number being treated elsewhere.
BV is a common cause of vaginal discharge. The discharge is usually whitish or greyish or sometimes yellowish, and tends to have an off-putting ‘fishy’ odour.
Unlike the discharges caused by thrush or trichomonas, it’s not usually associated with soreness, discomfort or itching.
It's uncertain if BV is transmitted sexually, especially as there's no equivalent condition in males.
Vaginal thrush (female candidiasis) Candida is a fungal infection. It loves warm, moist conditions, which is why it flourishes in women's vaginas – and also in babies' mouths, particularly in the newborn.
I'd like to stress that it's NOT an STD, and many people don't regard it as a sexually transmitted infection at all – though undoubtedly partners do sometimes pass it to and fro between them. That's why it's sometimes necessary to treat the male, as well as the female in order to eradicate the candida from the relationship.
Scabies Scabies (the itch) isn't actually a genital infection. But it's often dealt with at GUM clinics because of the fact that it's frequently acquired through being in bed with someone who has the condition.
It's caused by a little mite, which is just about visible to the naked eye. If your skin comes into contact with the skin of somebody who has scabies, some of the mites may well nip across from the other person's body to yours.
Crabs (pubic lice) Various kinds of lice affect humans. But the type that are associated with sex are pubic lice, which are easily transmitted from one person to another when two sets of pubic hair meet.
If you catch crabs from someone, you'll find that you have intense itching in your pubic area. By looking carefully, you may be able to see the tiny greyish lice crawling around. They do look a bit like minute crabs.
It may be easier for you to spot the white eggs (nits) that stick to the hairs.
How can sexually transmitted diseases be avoided? The less sexual partners a person has, the lower the risk of infection. Most sexually transmitted diseases can be avoided to a large extent by practising safe sex (eg using condoms). Avoid casual sex. If you're under the influence of alcohol or other drugs, don't even consider having sex with anyone. Most sexually transmitted diseases can be cured if they are diagnosed and treated in their early stages.
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Advantages of oral sex
What are the advantages?
Well, although it's not everyone's
cup of tea, for a lot of people oral
sex is fun. It can help 'spice up' a
relationship.
Oral stimulation given to a woman
is often an excellent way of getting
her aroused. Also, if it's practiced
by a reasonably expert partner, it's
an extremely effective method of
giving her an orgasm.
Many women who have had
difficulty in climaxing find that oral
sex helps them to achieve an
orgasm.
Similarly, oral sex given to a man is
something that many males find
exciting. Also, where an older man
is having difficulties with potency,
oral 'suction' can help with
inducing a good erection.
What types are there?
There are two main types of oral
sex. Sometimes a couple will
engage in both of them at the same
time.
Oral sex given to a woman by her
partner (whether male or female) is
called cunnilingus.
Oral sex given to a man by his
partner (again, female or male) is
generally termed fellatio, though
strictly speaking this word only
covers the type of oral caress in
which the penis actually enters the
partner's mouth.
Some couples practise cunnilingus
and fellatio at the same time. In
other words, the man has his
mouth on the woman's genitals,
while she has her mouth on his.
This activity is widely known as 'the
69' or 'le soixante-neuf', because of
the notion that when viewed from
the side, the couple's bodies look a
bit like the figures '6' and '9'.
Cunnilingus
Cunnilingus can be intensely
exciting for many women. It's also
satisfying for a man, who enjoys
giving his partner intense pleasure.
However, for 'first-timers' it can be
a somewhat overwhelming
experience. So, if either of you is
just learning and not used to this
type of thing, it's a good idea to
take things easy at the beginning.
Therefore, the man should avoid
making a sudden lunge for his
partner's genitals. A gradual
approach is usually better, taking
care to kiss her tummy and thighs
before slowly progressing to her
vulva. (The vulva is the external and
visible part of the female genitals.)
Useful tips include:
take care to keep things moist
begin by gently kissing the entire
area of the vulva
later, progress to kissing the
clitoral region
in the early stages, avoid direct
pressure on the clitoris, which is a
very sensitive organ
kiss just to one side of it, or just
above it – at least, during the first
few minutes of cunnilingus.
The most intense stimulation is
generally provided by using the tip
of your tongue on the clitoral area.
If properly done, this will bring most
women to a climax.
Fellatio
As noted above, the word fellatio
really means putting your partner's
penis in your mouth. But women
who are skilled lovers will also go
in for such techniques as kissing
the penis and licking it.
In addition, they may give oral
attention to the man's testicles,
although this is not as intensely
arousing as 'working' on the penis
– since there are far more nerve
endings in the penile shaft and
head.
Having a penis enter your mouth
can be a bit of a shock for an
inexperienced women. However, a
lot of females get used to it, and
indeed like it.
Nevertheless, the man should take
great care not to 'ram' his organ
hard into his partner's mouth. This
can cause great discomfort and
even gagging.
From the male point of view, the
softness, warmth and moisture of
the mouth clearly 'mimic' the
qualities of the vagina.
In addition, a partner's mouth has
two attributes that the vagina does
not possess.
There's a tongue – and this can be
used to swirl around the penis
during fellatio.
The mouth can create suction –
and this can be useful in creating
and maintaining an erection.
On the downside, the mouth has
teeth – and you need to take care
not to dig them into your man.
Some women make a practice of
covering their incisor teeth with
their lips during fellatio, but this is
quite difficult.
Females aged about 15 to 23 are especially likely to think that if a guy
wants to have sex with them, 'he must love me'.
Sex
Sex is a totally different matter.
Sex is of course the powerful biological urge that makes people want to
have intercourse, or some other form of sexual contact, with others.
In many ways, the word 'sex' more or less equates to 'love' or 'desire'.
Sex is the force that has kept the human race going, since it has made us
populate the planet.
It's to a large extent dependent on hormones, particularly testosterone.
And in general, it tends to be more powerful in males than in females –
though not always so.
This is why so many men get themselves into big trouble over sex, while
relatively few women do.
You might also notice a warm sensation in your abdomen. Try touching
yourself all over your body, including the breasts and your genitals where you will quickly find
the most sensitive spots. In particular, experiment near the opening of the vagina and clitoris
and stimulate yourself in whatever way feels best.
So long as you do not rush, and you are keeping relaxed, then your own fingers will
automatically do the right thing and will move with the right amount of speed and intensity for
you.
Try to familiarise yourself with exactly how touching yourself makes you feel. Ignore
everything around you. Just think about what is going on inside you, or fantasise about
making love with someone you care for, or with a celebrity, or in some gorgeous and
romantic place.
If, as is likely, your sexual tension rises, keep going. If you have never previously
masturbated to orgasm, you might suddenly feel tired and want to stop. Or you may be
nervous about the build up of excitement in your body.
For some women it is not enough to just use their fingers - they like to use sex aids as well. A
vibrator may be useful, or you could try stimulating yourself with the hand spray when you
are in the shower. Use your fingers at the same time.
This is particularly true for women who are between relationships and for whom
masturbation is the sole sexual activity at that period in their lives.
Most women find that their fingers do the trick wonderfully – as they instinctively match their
speed or weight to our requirements. But a vibrator can help someone who finds it hard to
get to orgasm and can also be useful as a change from digital masturbation.
When it comes to vibrators, don’t necessarily assume that something that is a market-leader
is necessarily going to be the best thing for you. It might not be. We all have different likes
and dislikes.
Sex and relationships

Why do we have sexual
dreams?
We dream because of the intense
activity that is constantly going on
in our subconscious minds. And
since sex is one of the most
powerful of all human drives, it's
not surprising that so many dreams
have a strong sexual content.
If we have deep urges to do certain
things, they are highly likely to
come out in our dreams – where
our consciences cannot prevent
them happening.
But isn't it true that our
consciences 'censor' sexy dreams?
Yes. The mind has something called
a 'dream censor', which tends to
'clean up' dreams.
So, if a person who has a very strict
puritanical outlook starts to have a
sexy dream, their dream censor
may alter that dream so that very
'rude' things are replaced by
symbols.
Thus, a man of strict sexual morals
may have a deep, unconscious
desire to have sex with beautiful
women. Instead of dreaming about
vaginas, he will keep dreaming
about tunnels and subways. Instead
of dreaming about breasts he will
dream about pleasant hillocks and
mounds - and so on.
Similarly, a woman whose sexual
morality is very strict won't dream
of penises. Instead, she'll dream of
penile symbols, like:
Do people have orgasms in
dreams?
Definitely! Women don't do this very
often, but it does happen -
especially at times when they're
'highly charged' sexually.
When we were writing our book
The Big 'O' (Hodder: 1995), a
sizeable number of women
reported to us that their first ever
orgasm was in a dream.
However, it's more common for
women just to get very excited
during a dream – and then to wake
up on the brink of orgasm and
'finish themselves off' by self-
stroking.
When are you too old to have sex?
Never. Many men and women continue to have a satisfying sex life when
they get older. If a person feels like it, there's no reason why sex should
not continue into the 70s or 80s. There aren't any limits, providing the
desire is there for both partners.
We have recently seen patients of almost 90 who were still enjoying a
loving and happy sex life together – some of them with the help of
medications such as Viagra. And we wish them the best of luck!
Simultaneous orgasm
The notion that simultaneous orgasm is the norm is simply a myth.
There's a great deal of misunderstanding about the subject of simultaneous orgasm. This is
when a couple orgasms at the same time.
It's clear that a lot of people, and especially younger women, think that a male and a female
are supposed to reach orgasm at the same moment, every single time! In the real world, this
just isn't true.
How to achieve simultaneous orgasm
For many couples simultaneous orgasm is not going to happen, at least on a regular basis.
Many of them just accept this, and maybe that's not a bad thing, if they're both happy.
But if you really want to 'come' in the same instant as your partner, it can be done.
Here' a guide to help you.
1. Learn how to ensure that the female partner can orgasm more or less at will, during
sexual intercourse.
If you work at it over a period of time and are always in a loving, romantic, unhurried
atmosphere – this isn't all that difficult to achieve.
The trick is to make sure that you can reach the woman's clitoris, with the fingertips during
intercourse. When you're both nearly ready to 'come' then rub it gently but enthusiastically.
2. Exploit the advantages of multiple orgasms.
If the female partner has learned how to have multiple orgasms, that makes the objective of
simultaneous orgasms a lot easier.
Why? Because the male now has a number of different 'targets' to aim at.
In other words, if he isn't ready to climax by the first time she comes, he can always do it
when she orgasms for the second, third or fourth time.
But the ability to reach multiple orgasms isn't very common in younger women. Females tend
to learn it as they get older.
This underlines the fact that simultaneous orgasms are a lot easier for couples who have
been together a long time in a loving relationship and who really understand each other's
bodies.
3. Make sure that the man learns to control the timing of his orgasms.
Frankly, this might take years to do! But there's a strong tendency for men to learn more
control as they get older.
A lot of 40 and 50 year olds can simply make love for hours on end and then ejaculate when
the woman is ready.
What did your PARENTS
told you about sex?
Here are two facts that you
almost certainly weren't told
by your mother. But knowing
them could help you to a
more enjoyable sex life.
-------------------
Fact one: climaxing isn't that
easy
For most females, learning to
climax is quite a difficult and
time-consuming business.
Nowadays, men tend to
suggest to women that they
should be able to reach
orgasm very easily.
--------------------
Fact two: almost any woman
can ‘come’
Practically any woman should
be able to have orgasms -
and indeed multiple orgasms
- if she really wants to.
Back in your mum's day, sex
was still quite a taboo
subject and talking about
orgasms was even more
taboo.
Furthermore, when your
Mum was young, many so-
called 'experts' suggested
that multiple orgasms were
almost impossible for most
females.
However, we now know that:
any woman can have an
orgasm – if her clitoris is
stimulated long enough and
expertly enough (and of
course provided that she's in
the right mood!). Further
intense stimulation after the
first orgasm will usually
produce another.. And
another... And another...
We're not saying that you can
achieve all this overnight
but, if you stimulate your own
clitoris for long enough over
a period of time, you are
quite likely to eventually
achieve as many orgasms as
you like.
Clearly you can also have
multiple orgasms if you have
a partner - male or female -
Women's sexual response
Do all women have the same sexual feelings? No they don't. In actual fact, women vary
enormously in their sexual drive. Some don't feel very interested in sex at all – whereas
others are passionate and wild about it.
Learning how to reach orgasm
We have found that younger females frequently have no real knowledge of the process
of sexual arousal. In particular, women often need quite a lot of help to learn how to
reach orgasm.
Unlike males – most of whom can 'come' easily from the moment they reach puberty –
females will often spend a couple of years experimenting with their sexual feelings
before they eventually learn how to come regularly and reliably.
But once women have learned to cast off their inhibitions and enjoy sex, they tend to
respond to sexual stimuli in very much the same way.
What happens to her sex organs as she
gets aroused?
Laboratory studies carried out in Holland in 2004 show that as s soon as a woman
starts thinking with interest about sex, her vagina begins to moisten. (This is the female
equivalent of erection in men.)
The reason for this moistening is to lubricate her vagina, in preparation for possible
sexual activity.
At the same time, various other things happen:
her clitoris – the most erotically sensitive part of her body – swells up.
her labia (the lips of the opening of her vagina) also swell up. The effect of this is to open
up her vaginal opening slightly, in preparation for intercourse.
inside her, her vagina opens up – making room for the possible entry of a penis.
What happens next?
As she gets more and more aroused, her breasts will swell a little and her nipples will
become more prominent. Her breathing gets faster and she starts to gasp. Her eyes
tend to become glazed and she is likely to lick her lips - thus making them even more
attractive to her partner.
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Love and sex
Many people get mixed up between the concepts of love and sex.
One of the big problems that troubles human relationships is this: many
young women – and young men – get very muddled up between love
and sex.
You can see examples of this confusion all over the place. For example,
people use the expression 'making love' as a polite euphemism for
'having sexual intercourse'.
Incidentally, half a century ago that expression 'making love' often just
meant 'flirting'.
Another source of confusion is the fact that there are many books and
magazines that use the word 'love', when they really mean 'sex'.
What is 'love'?
If you check any dictionary, you'll find that of course the word 'love'
doesn't mean 'sex' at all.
Broadly speaking, the phrase 'to love' means to like someone (or
something) intensely. The meaning is similar to that of the expression 'to
adore'.
Dictionaries and encyclopedias make clear that our present-day notion of
love comes from various ancient Greek ideas.
These days, we can legitimately use the word 'love' to cover several
different things.
1.The powerful emotion of romantic love that so many couples
(heterosexual and same-sex) feel for each other.
2.The strong love that members of a family often have for one another, eg
in the case of parents and children.
3.The love that some great friends feel for each other.
4.Perhaps the strong love that many people have for things like music or
art.
In contrast, it doesn't really seem appropriate use the word 'love' in the
casual way that so many people do, in order to indicate mild approval or
interest for something – as in 'I'd love a bit more pudding'.
How sex tends to accompany love
Another thing that 'muddies the waters' between love and sex is this.
Most people who fall in love with each other find that they desperately want
to have sex together.
That's not an invariable rule, but there are few loving couples who don't
feel the strong urge to go to bed together and enjoy sexual intercourse.
Very often, what happens at the same time is that they start to feel that they
no longer wish to have sex with anybody else.
So, those who experience the phenomenon of 'true love' are likely to say
that they intend to be faithful to their beloved for life. And in many cases,
they really do manage to do this.
Sex as a 'love-promoting' factor
One other phenomenon to watch out for is this. People who have sex with
each other a few times, and who find that it's gone really well, often tend to
discover that they are starting to fall in love with each other.
What's the best way for women to have an orgasm?
If you don't know exactly what it is you like or what it takes for you to reach orgasm, it's a
good idea to practise on your own.
For some people the very idea of stimulating themselves can seem worrying, or
unappealing, or something to be ashamed of. It’s a good idea if women can rid themselves
of these feelings.
Masturbation is a great way to lessen tension in your body. It’s a very safe way to have an
orgasm. And it’s probably the best way to learn about how your body likes to be loved. . But
masturbation, like most things, takes practice. And the only way to learn about your own
sexual response is to try it.
If you have never tried masturbation, or you want to do it in such a way that will be more
pleasurable and satisfying then it has been in the past, then you might need to plan how and
when to do it, rather than leave it to chance. For a start, you need to ensure that you’re
going to have adequate time to yourself and that you won't be interrupted
Masturbation for women -- Is masturbation a good thing? What's the best way for women
to have an orgasm?
To masturbate means to stimulate yourself in a sexual way. This can be done by hand, or
with sex aids – some highly-sexed women can even do it by rubbing their thighs together.
And a tiny minority of women can do it with no genital contact at all, but simply through
caressing their breasts.
Most men have masturbated, often beginning at
a fairly young age.
Women tend to start masturbation later however, and it does
not tend to be such an automatic activity as it is for most men
and boys.
Furthermore, even once a woman has learned to masturbate,
she will probably do it less than the average man - and it seems
that far fewer women than men do it regularly.
What's the best way for women to have an orgasm?
Begin by taking a shower, or a long, luxurious, scented bath.
Soap your body all over and enjoy touching your breasts and
your genitals in particular.
Dry yourself carefully, then rub your favourite lotion all over your
body. Keep touching your body everywhere - it might be a good
idea to stand in front of a mirror while you do it. This is your body
– a body capable of giving you great pleasure – so enjoy looking
at it and getting used to the sight and feel of it.
At this point, as long as you know that you're in no danger of
being disturbed, move to your bedroom. Make sure that it is
warm and comfortable. Put on some relaxing music if you like.
And just enjoy yourself.
Lie down on your bed and use a mirror to look at your private
and intimate places. Gently spread your labia: you may want to
use a spot of lubrication There are very nice modern ones that
increase the sensuouness of the occasion – such as Wet,
Liquid Silk and Pjur. But if you don’t have any lubrication, then
use saliva.
Try to tighten and relax the muscles at the base of the pelvis.
If you find it difficult to know whether you're doing this
successfully, try inserting a couple of fingers inside your vagina.
That way, you'll be able to feel whether you're tightening and
relaxing the muscles or not. Many women much prefer
masturbation if they can feel some bulk in the vagina at the
same time as they stimulate the clitoris – so touching yourself
internally might feel very good indeed.
Most men have masturbated, often beginning at a fairly young age.
Women tend to start masturbation later however, and it does not tend to be such an
automatic activity as it is for most men and boys.
Furthermore, even once a woman has learned to masturbate, she will probably do it less
than the average man - and it seems that far fewer women than men do it regularly.
What's the best way for women to have an orgasm?
Begin by taking a shower, or a long, luxurious, scented bath. Soap your body all over and
enjoy touching your breasts and your genitals in particular.
Dry yourself carefully, then rub your
favourite lotion all over your body. Keep touching your
body everywhere - it might be a good idea to stand in front of a mirror while you do it. This is
your body – a body capable of giving you great pleasure – so enjoy looking at it and getting
used to the sight and feel of it.
At this point, as long as you know that you're in no danger of being disturbed, move to your
bedroom. Make sure that it is warm and comfortable. Put on some relaxing music if you
like. And just enjoy yourself.
Lie down on your bed and use a mirror to
look at your private and intimate places. Gently
spread your labia: you may want to use a spot of lubrication There are very nice modern
ones that increase the sensuouness of the occasion – such as Wet, Liquid Silk and Pjur.
But if you don’t have any lubrication, then use saliva.
Try to tighten and relax the muscles at the base of the pelvis.
If you find it difficult to know whether you're doing this successfully, try inserting a couple of
fingers inside your vagina. That way, you'll be able to feel whether you're tightening and
relaxing the muscles or not. Many women much prefer masturbation if they can feel some
bulk in the vagina at the same time as they stimulate the clitoris – so touching yourself
internally might feel very good indeed.

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Priapism of the clitoris..
''Painful, Days-Long Erections
Also Happen in Women''
Female Priapism is defined as a
persistent painful erection lasting for
more than 6 hours and unassociated
with sexual arousal.
Female priapism is a very rare
condition," the researchers said. Nevertheless,
the condition "can be very embarrassing as well as
painful, and must be treated urgently to alleviate
symptoms."
Priapism often happens because
the vessels that drain the blood from the sex organs
become blocked, or the systems that relax the organs
fail. The condition can lead to severe engorgement,
swelling, and in severe cases, blood clots and fibrosis

Erectile Dysfunction Guide
Male Pri·a·pism = (prī'ă-pizm),
Priapism Types, Signs, Causes, &
Treatment
Persistent erection of the penis, accompanied
by pain and tenderness, resulting from a pathologic
condition rather than sexual desire; a term loosely used as
a synonym for satyriasis.
------------
Priapism is a medical condition in
which the erect penis does not return to its flaccid state,
despite the absence of both physical and psychological
stimulation
-----------
Priapism is a persistent, usually
painful, erection that lasts for more than four
hours and occurs without sexual stimulation. The condition
develops when blood in the penis becomes trapped and is
unable to drain. If the condition is not treated immediately,
it can lead to scarring and permanent erectile dysfunction.
Priapism can occur in all age groups.
----------------
There are two main types:
• Low-flow or ischemic priapism: This
type happens when blood gets trapped in
the erection chambers. Most of the time, there’s
no clear cause, but it may affect men with sickle-cell
disease, leukemia (cancer of the blood), or malaria. If you
don’t get treatment right away, it can lead to scarring and
permanent erectile dysfunction (ED).
-----------------
• High-flow or non-ischemic
priapism: This type is more rare than low-flow and is
usually less painful. It often happens when an injury to the
penis or the area between the scrotum and anus, called
the perineum, ruptures an artery, which prevents blood in
the penis from moving normally.




Priapism is a condition in which a penis remains erect for hours in the
absence of stimulation or after stimulation has ended. There are three types:
ischemic (low ...
Causes: Sickle cell disease, antipsychotics, SSRIs, blood thinners,
cocaine, cannabis, trauma.. Symptoms: Penis remains erect for hours.
======
Diagnosis:
The diagnosis is often based on the history of the condition and the physical
exam.
Blood gas testing the blood from the cavernosa of the penis can help in the
diagnosis. If the low flow type of priapism is present the blood typically has a
low pH while if the high flow type is present the pH is typically normal.
Color doppler ultrasound may also help differentiate the two.[3] Testing a
person to make sure they do not have a hemoglobinopathy may also be
reasonable.
Treatment:
Medical evaluation is recommended for erections that last for longer than
four hours. Pain can often be reduced with a dorsal penile nerve block or
penile ring block. For those with nonischemic priapism cold packs and
pressure to the area may be sufficient.
Aspiration:
For those with ischemic priapism the initial treatment is typically aspiration of
blood from the corpus cavernosum. This is done on either side. If this is not
sufficiently effective then cold normal saline may be injected and removed.
Medications:
If aspiration is not sufficient a small dose of phenylephrine may be injected
into the corpus cavernosum.
Side effects of phenylephrine may include high blood pressure, slow heart
rate, and arrhythmia.
If this medication is used, it is recommended that people be monitored for at
least an hour after.
For those with recurrent ischemic priapism diethylstilbestrol (DES) or
terbutaline may be tried.
Surgery:
Distal shunts, such as the Winter's,[clarification needed] involve puncturing
the glans (the distal part of the penis) into one of the cavernosa, where the
old, stagnant blood is held.
This causes the blood to leave the penis and return to the circulation. This
procedure can be performed by a urologist at the bedside.
Winter's shunts are often the first invasive technique used, especially in
hematologically induced priapism, as it is relatively simple and repeatable
