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Pripasim with pain - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Sexual Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
Doctor :   Hi
Doctor :  
How can i help you?
User :   Hello, I don't know if we talked before
User :   I was discussing a priapism with someone earlier
Doctor :  
User :   was that you? It only ever says doctor on here
Doctor :  
no it was not me
User :   well, I had a priapism a while back, six months ago
Doctor :   ok
User :   I went to sleep with an erection, woke up with it, and it was never painful
User :   so I didn't think much of it
User :   but after a while of being awake, it didn't go down
Doctor :  
User :   as best as I can tell, I had a 12-18 hour priapism. it wasn't painful, but my flacid penis hurt the next day
Doctor :  
User :   so I went to the dr, who said I was just sore, and that it would get better in a week. It did
Doctor :  
User :   but two months later it started to ache again, and hasnt stopped for like, 4 months
User :   I went to a bunch of urologists, and they all said it wasn't fibrosis or scaring
Doctor :  
User :   I had a doppler done four months after the priapism, it didn't show anything
Doctor :   ok

User :   the doctors all say they don't feel fibrosis or scaring
User :   but the pain won't go away, and I am still afraid that the fibrosis could be developing slowly
User :   so my question is, could the pain be slowly developing fibrosis, or would the doctors know if it was there by six months?
Doctor :   fibrosis is a condition where the normal tissue is replaced by fibrous tissue
Doctor :  
if fibrosis is there then there will be some amount of deformity
User :   right, but even after five, six months?
Doctor :   occurrence of fibrosis cannot be predicted in an normal tissue
Doctor :   if there is an injury and predisposing factor like tubercular infection than fibrosis can be anticipated
Doctor :  
why do you think there is a fibrosis being developed in the penis?
User :   well because I had a long priapism, and now months later it hurts
Doctor :  
is it a sign for the development of fibrosis?
User :   the pain? I don't know
User :   is it?
Doctor :  
please don't assume things for yourself
Doctor :   it causes more distress
User :   well, I just know that priapisms can cause it, then I had this pain for two months
User :   or two months later
User :   I still have the pain
User :   so the continuing pain months after the priapism makes me think the two are connected
Doctor :   even after doctors have rule out the fibrosis part??
User :   well, they haven't really completely ruled it out. They've felt it, run a doppler, and said probably not. But even they say it can take a while to develop
User :   they just doubt it. Most of them seem to t hink its all in my head
Doctor :  
User :   my question, as a second opinion is, should a doctor be able to just feel my penis five months after the priapism and be basically sure theres no fibrosis
User :   ?
Doctor :   yes
Doctor :  
if there is a fibrosis the doc will able to do so
Doctor :  
by the palpation of the penis
User :   I mean, is that an accurate time frame for me to not worry that it could still develop
Doctor :  
time frame i cannot say
User :   palpation right. So five months is enough time for him to do that in?
User :   oh
Doctor :   but the diagnosis can be made by palpation
User :   well, ok, same with the doppler? You don't know if it would catch it four months in
User :   see, I am concerned that I keep having people check, and it takes two years to show up or something
Doctor :   doppler do not detect the fibrosis it detects the state of the blood vessels and the blood flow in it
User :   ahh, well I was told that the doppler could look for the damage caused by a priapism
Doctor :   yes damaged caused to the blood vessels
User :   hmm. So, then
User :   The doctors don't see anything for now, but do you think that the pain could be the still developing fibrosis?
Doctor :   the pain in penis is the reflection of your fear of developing fibrosis in the penis.
Doctor :   the developing fibrosis do not cause pain as such
User :   well I am pretty sure I am feeling this pain
User :   oh, fibrosis doesn't cause pain?
User :   I mean, not ongoing, aching pain?
Doctor :   fibrosis around a nerve might cause pain in the nerve
Doctor :   and ongoing fibrosis rarely causes pain by entrapping a nerve
User :   so you don't think the description of my pain matches ongoing fibrosis?
Doctor :   one more thing
Doctor :  
fibrosis may be the cause of Priapism and not the result of it usually
Doctor :  
the most common complication to occur is the damage to blood vessels in the penis giving rise to erectile dysfunction
User :   would that have occured by now
Doctor :   yes
User :   so that the doppler would have caught it
Doctor :   very much
User :   I see
User :   well I know that fibrosis can come from a long priapism
User :   so I'm just worried about it
Doctor :   long priapism will cause ischemia to the penis tissue and damage to the blood vessels
User :   well, do you think 12-18 wasn't too bad. As I said, it didn't hurt
User :   ?
User :   and wasn't completely erect when I woke up
User :   another question..... so it wasn't painful or fully erect, but hurt later. If the priapism let up a little, like half a priapism, does it stop being ischemic?
Doctor :   since there is no erectile dysfunction probably you have escaped the ischemic injury and so it was not sufficient to cause the erectile dysfunction and or the fibrosis
User :   and I would know that by now?
Doctor :   yes
User :   ok, so just to clarify
Doctor :   priapism means painful and persistent erection beyond 4 hours
User :   if it lets up, and becomes only half erect, and nonpainful, it is no longer ischemic?
Doctor :  
you say there was not pain during the long erection episode
User :   well, during the waking part. The sleeping part, dunno, I was drunk
User :   could have hurt for like 10 hours or so, I wouldn't have noticed unless it woke me
Doctor :  
priapism is a painful condition and it will cause severe pain for you to go to emergency department for the treatment
User :   well, alright, it didn't until a day later
Doctor :  
User :   which of course, the other doctors just say was soreness from prolonged semi erection
Doctor :  
User :   see, I was on viagra
Doctor :   thats true
User :   I didn't say that
Doctor :   see here is the cause for the prolonged erection
User :   and I think that made it last a while longer than it should have
Doctor :   very much
User :   but you don't think it was a true, ischemic priapism?
Doctor :  
see it is just a medication induced prolonged erection and not priapism
User :   but you don't think it was a true, ischemic priapism?
Doctor :   no
User :   ok, so to clarify, you don't think the pain I'm having describes the symptoms of fibrosis?
Doctor :   yes
User :   yes, you don't
User :   so no, you don't
Doctor :   meaning?
User :   you don't think it is fibrosis
User :   ?
Doctor :  
yes i dont think it is fibrosis
User :   ok
User :   well thanks
User :   by the way, whats your name, I mean which doc are you?
User :   are you allowed to say?
Doctor :   dr shekar
User :   thanks
Doctor :  
and i am a general practioner
User :   ok, well I trust you know enough about urology
Doctor :   yes
User :   cool
User :   thanks
Doctor :  
is there anything else i can help you with
User :   no, thanks for your time
Doctor :  
please fill the feed back form
Doctor :   thanks for consulting healthcare magic
Doctor :  
we are available
User :   thank you
Doctor :  
please do log in if you have any medical query
Doctor :  
bye for now
User :   bye
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