How to suppress an erection

Generally speaking, when a man is stimulated physically, the corpus cavernosum of the penis will become engorged with blood, and the penis will then become erect. However, sometimes it is necessary to suppress erection, such as when a man undergoes circumcision surgery. If the penis becomes erect immediately after the surgery, this may cause the incision to be stretched open, resulting in repeated bleeding. On the one hand, this stimulation should be avoided, and on the other hand, some medications can be used for treatment under the guidance of a doctor.

How to suppress an erection

1. Non-surgical treatment

⑴ Low blood flow type abnormal penile erection: The treatment goal is to increase venous blood return to reduce penile swelling, prevent damage caused by prolonged ischemia of the corpus cavernosum, and relieve pain. Drug treatment should be tried before surgical treatment. It should be noted that drug treatment prolongs the treatment time and increases the chance of fibrosis of the corpus cavernosum and erectile dysfunction. It has been reported that the incidence of low blood flow type impotence is as high as 50%. If it is cured with drugs within 12 to 24 hours, the penile erectile function can almost be restored. Kulmala and Tamella (1995) observed that in most cases, if suction and α-adrenergic hormone treatment were used within 36 hours, the corpus cavernosum would not undergo fibrosis. If it exceeds 36 hours, α-adrenergic drugs will be ineffective and varying degrees of fibrosis will form in the corpus cavernosum.

Abnormal penile erection

There are reports of injecting a diluted solution of the α-adrenaline agonist into the corpus cavernosum of the penis, adding 1 mg of adrenaline to 1000 ml of saline. First, use a 21-gauge needle to aspirate the blood in the corpus cavernosum, then inject 20 ml of the diluted solution into the corpus cavernosum, aspirate the blood again after 2 minutes, and repeat the injection and aspiration several times until the tumor disappears. There is also a method of adding 10 mg of phenylephrine to 500 ml of saline, with 10 to 15 ml injected each time. If the treatment is carried out within 12 hours of onset, satisfactory results can be achieved.

Recurrent priapism often occurs in patients with sickle cell anemia or those with a history of priapism. Young patients can be treated with a dilute phenylephrine solution. For patients with no sexual function, antiandrogens or gonadotropin-releasing hormone agonists can be used to inhibit nocturnal erections and prevent recurrence.

Complications of drug therapy include acute hypertension, headache, palpitations and arrhythmia caused by alpha-adrenergic drug therapy, infection, bleeding and urinary fatigue injury.

(2) High blood flow type abnormal erection: Early local ice pack cold compress causes blood vessels to contract, and damaged blood vessels may spontaneously form thrombi. Most ruptured cavernous arteries cannot heal on their own and often require internal pudendal artery angiography and embolization. There are reports that intra-arterial injection of methylene blue and injection of autologous blood clots for embolization treatment have been successful in recent years.

2. Surgical treatment Currently, there are fewer and fewer cases suitable for surgical indications.

Non-ischemic priapism is usually treated non-surgically in early ischemic cases, and the penis can be converted to non-ischemic after adequate irrigation.

If the corpus cavernosum fails to be treated with suction and flushing, the corpus cavernosum can be directly incised from the glans penis to both sides or a biopsy needle can be inserted through the glans penis into both sides of the corpus cavernosum to extract tissue, so that a shunt channel is formed between the glans penis and the corpus cavernosum. In the anastomosis of the proximal urethral corpus cavernosum and the corpus cavernosum of the perineum introduced by Sacher (1972), it is important to avoid the anastomosis on both sides being on the same horizontal plane to prevent the occurrence of urethral stenosis.

In some cases of high-blood-flow priapism, when simple arterial embolization is ineffective, ligation of the supplying blood vessels of the torn artery is necessary to be effective.