Wednesday, January 10, 2007 One ‘big’ male problem By Zosimo T. Literatus, R.M.T. Breakthroughs
“AFTER great pain,” wrote Emily Dickinson in her poem After Great Pain, a Formal Feeling Comes (Further Poems), “a formal feeling comes/The Nerves sit ceremonious like tombs.”
Pain and depression come hand in hand when helplessness is in the picture. Here’s one from Mr. A. (name withheld on request) of Cebu City through a text message:
“Hi Zosimo, I’m A., a big fan of your column. I have a big problem. My erections don’t subside for almost 24 hours. I’m depressed.”
The name of the condition is priapism, which is a prolonged and persistent erection of the penis without sexual stimulation and failure to subside despite orgasm. And it is painful.
In a 2003 study, a team of six German physicians from the University Hospital Schleswig Hoslstein (Campul Kiel, Germany), led by C. van der Horst, reviewed existing scientific knowledge about priapism.
The findings were published in the International Brazilian Journal of Urology (2003). Priapism can be caused by excessive release of chemicals that control penile contraction, malfunction of the penile swelling itself, obstruction of the draining blood vessels, or prolonged relaxation of the penile smooth muscle.
Priapism of beyond 48 hours can cause irreversible hardening of the penile smooth muscle resulting to impotence. Depending on the cause, less invasive procedures are more and more successful and are first-choices to correct it.
The oral treatment recommended is Terbutaline sulfate (5 milligrams, frequency not indicated). Injections are available. Bur priapism is not for self-medication. A physician must be consulted.
Most common of invasive methods is the Winter shunt (success rate: 50 to 60 percent). A cut passage is made between the penile head and its blood compartment. Possible complications are blood compartment infection with pus buildup, urethral (urine channel) injury, and penile clot formation leading to erectile dysfunction. The last complication (50 percent of cases) is the reason why invasive procedures are last resorts.
Van der Horst considered priapism a “urologic emergency and should be treated prompt and consequent.”
Lewis Wolpert, in his book The Malignant Sadness, wrote: “Ultimately, those who are depressed have to take responsibility for their own condition and so need to understand as much about it as possible.”
So, A., you have taken the correct first step when bringing up the concern with your doctor. The rest, as you see, is still under your control. (For comments and suggestions, email to ztliteratus6046@lycos.com or text to 0927-979-3519.)
