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    What causes swelling of penis when lying down?

Posted on Tue, 21 Apr 2015 in Urinary and Bladder Problems
Question: Dear. Dr. After fall injury, I have been having swollen penis/semi-erect when lying down, subsides when standing up or after walking for 10-15 minutes. Weird thing is when i sleep, i would get totally rigid corpus cavernosum and soft XXXXXXX & corpus spongiosum erection that would wake me up from sleep. I would have to wake up and walk around for these erections to go down. They would go semi-erect then it would take anywhere between 15-30 minutes for blood to drain. (as if vein drainage was blocked,,)

Went to urologist and did a doppler test for possible high flow priapism, however, it did not show anything (high flow priapism usually with high PSV) but my psv was 28cm/s and got a ischemic priapism from the doppler test which I had to get 2 injections to get rid of.

Urologist said everything was okay as per doppler, but my symptoms persisted and they decided to do an angio to take a look if there was something else going on. On the angiogram, on the proximal part (close to base/pubic) penis there was blush (not fistula) that extended all the way down to XXXXXXX of penis. Hence they embolized the suspected artery.

For the 1st time in months I did not get these painful night erection. by the 2nd day I got 20% chubby erection, then 3rd day back to these rigid night time erections. Now, I am waking up every 1 hour to prevent and drain the blood. I slept through couple times, woke up with severe pain & extreme coldness as if my blood circulation is cut off. My erectile function is deteroiating as well with these episodes,

Doctors are confused. Is there any possibiltiy that I might have high-flow priapism as well as veno-occlusive dysfunction? Any help would be appreciated
Answered by Dr. Rishi 6 hours later
Brief Answer:
Will have to repeat Angiography.

Detailed Answer:
Hi. It is possible that both happening at the same time due to the injury. There is only so much that can be treated. To know what's happening I would not be able to comment without a repeat Angiography. If you are not treated then a repeat Angiography should let us know what is wrong. Tell them to take venous run off also by taking delayed images and let me know.
Take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
Answered by
Dr. Rishi

General Surgeon

Practicing since :1999

Answered : 1312 Questions


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