Penile Tattoo Risks & Side Effects + Priapism Treatment & Prevention

Man gets permanent erection from tattoo: An erect penis for three months — is this great or is it dangerous? However exciting being Mr. Permanent Hardick may sound, doctors say this is not only bad but can even be a medical emergency.

In a recent paper, doctors from the Kermanshah University of Medical Sciences in Kermanshah, Iran wrote on the first reported case of a man who got a permanent semi-erection after having his penis tattooed.

Doctors diagnosed the 21-year old man, who presented himself at the hospital with “a partially rigid penis of three-month duration,” with non-ischemic priapism, the ABC News Blog reports. This condition results from the inability of blood to exit the penis.

The Iranian man got his semi-erection after having his penis tattooed with the worlds “borow be salaamat” (good luck with your journeys) and the letter “M” (his girlfriend’s initial). Researchers detail this first known case of non-ischemic priapism following penile tattooing in the January issue of the Journal of Sexual Medicine.

“Most probably, the handheld needle penetrated the penis too deep, creating an arteriovenous fistula,” write Dr. Javaad Zargooshi and colleagues in their report. A fistula is a connection between two organs or vessels that don’t normally connect. In this case, it was an artery and a vein that made the unwanted connection.

“For eight days after tattooing, the penis was painful, and thus there were no erections,” the authors wrote. “After that, the patient noticed longer-than-usual sleep-related erections. This progressed, within a week, to a constantly half-rigid penis, day and night.”

While this might sound like bliss for men suffering from erectile dysfunction, it really isn’t.

Doctors warn men who have an erection lasting more than four hours to seek medication attention — and for good reason: one form of prolonged erection is considered a medical emergency.

A prolonged and painful erection that occurs without sexual stimulation is called a priapism, which can be either ischemic (no-flow) or non-ischemic (high-flow).

Ischemic priapisms — the most common kind — usually occur with several hours or days of a painful erection. Caused by an obstruction in the penis’ venous drainage, this results in a buildup of poorly oxygenated blood in the tissue that forms the bulk of the penis.

Considered an emergency, ischemic priapisms require immediate treatment. If left untreated, extensive scar tissue can build-up, damaging erectile function significantly and causing impotence.

Like in the Iranian man’s case, a non-ischemic priapism is not common — or painful. Usually caused by an injury to the penis or the perineum, the area between the scrotum and anus, the injury causes the artery in the erectile body to rupture and pump large amounts of blood to the penis continuously.

In a normal erection, blood rushes into the penis through the arteries to build up pressure and leaves later through the veins. But when the erectile artery is injured it pumps blood faster than it can leave, causing pressure and permanent erection — a non-ischemic priapism.

Such was the case reported by the Iranian researchers. To treat the man, doctors first investigated and ruled out known causes of priapism: perineal injury, leukemia, sickle cell trait, thalassemia and urinary tract infection. Other neurogenic, neoplastic, infectious, toxic and drug-related causes were also probed and ruled out.

The young man’s penis was then numbed with local anesthetic and, using a small needle and syringe, excess blood was drained or aspirated. Lab analysis of the aspirated penile blood showed that it was bright red, with cavernous blood gas measurements confirming high oxygen and low carbon dioxide content — characteristics of arterial priapism.

Often, doctors also use aspiration to treat priapisms. After blood is drained, the penile veins are flushed with a saline solution. This usually relieves pain, clears the tissues of oxygen-poor blood, and may stop the erection. The treatment may also be repeated until the erection ends.

But for the Iranian man, the treatment did not work. In cases like these, patients are given the option of selective arterial embolism — a surgery to block the offending artery. Doctors treating the young man wanted to insert special material that would block blood flow to his penis temporarily — in time, such material would be absorbed by his body. This procedure is called embolization.

Since there was no embolization facility in Kermanshah and few experts in superselective embolization as well, the doctors referred the patient to another hospital for superselective embolization. But he chose to have a shunt implanted to drain the excess blood, Dr. Zargooshi and his colleagues report.

“Predictably, the procedure was unsuccessful,” the authors write. “Because of the painless nature of erections, moderately good preservation of erectile function during intercourses, and disappointment with former surgery, the patient has declined to undergo further therapies, and lives with his condition.”

According to the report, despite his permanent erection, the man has no regrets over his penis tattoo. Still doctors warn, “based on our unique case, we discourage penile tattooing,” they write.

What to do if you have a priapism?
Whether or not your permanent erection is painful, it’s best to see a doctor, who will diagnose if your priapism is the milder or more dangerous type.

Diagnosis involves taking a medical history and an exam to determine the duration of your condition and the underlying medical causes. During the medical exam, your doctor will assess the severity of pain, the rigidity of your penis and identify which parts of the penis are involved.

The exam also includes checking the rectum and abdomen for unusual growths or abnormalities that may indicate cancer. A sample of your blood will also be taken and analyzed to eliminate sickle cell disease, thalasemia major and leukemia as causes of your priapism.

To determine if you have a non-ischemic priapism, your doctor will also conduct a Doppler exam to measure the blood flow of your penis.

Just as was done to the young man in the case study, a small needle may be used to draw blood from your penis, which is then sent to a lab for analysis. This will help determine which type of priapism the patient is experiencing.

How will my priapism be treated?
For all forms of priapism, treatment aims to eliminate the erection and pain, as well as preserve normal erectile function.

If the ischemic priapism is in its early stages, a simple cold shower or ice pack may relieve symptoms. Exercise like climbing stairs may also help, and analgesics and opiates can be used to control pain. Aspiration, the procedure done on the Iranian man, is often found to be effective.

When this fails, doctors may prescribe medication. Drugs called alpha-agonists or alpha-adrenergic sympathomimetics, like neosynephrine or phenylephrine, may be injected into the penis’ spongy tissue.

This drug will constrict blood vessels transporting blood into the penis and limit its flow, allowing blood vessels transporting blood out of the penis to open up—causing the erection to subside.

The medications may be taken repeatedly over several hours, if needed. But there’s a risk of side effects particularly if you have high blood pressure or heart disease: headaches, dizziness and high blood pressure.

When drugs and aspiration don’t work, doctors may suggest a surgical implantation of a shunt—a device to reroute the blood flow so that it moves through your penis normally.

Men who have sickle cell anemia will also have to go through additional treatments for disease-related episodes, like supplemental oxygen or an intravenous solution to keep you well hydrated.

Non-ischemic priapisms
With non-ischemic priapisms, there’s no risk of damage to the penis, so doctors may suggest a watch-and-wait approach. What’s more, such priapisms often go away without treatment. Putting ice and pressure on the perineum—the area between the base of the penis and the anus—may help end the erection.

When this doesn’t work, surgery may be recommended to insert a special material — which eventually gets absorbed by the body — to temporarily block the blood’s flow to the penis. Surgery may also be needed to repair arteries or tissue damage resulting from an injury.

Blocking the flow of blood to the penis can be done by embolization — inserting specially designed coils, glues or spheres into the penis. Or, it can be done by surgical ligation, or tying off the ruptured artery to help restore normal blood flow in the penis.

What can I do to prevent priapism?
If you want to prevent priapism in the first place, you may:

• Treat the disease that may cause priapism
• Change medications if a prescription drug can cause priapism
• Avoid triggers like alcohol or illegal drugs
• Self-inject with phenylephrine to stop prolonged erections
• Undergo hormone treatment—but only for adult men
• Take a prescription muscle relaxant, such as baclofen (Lioresal)

SOURCES for this article include: ABC Health Blog, Wiley Online Library, ucsfhealth.org, and the Mayo Clinic

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