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Warning-sign checks

Priapism: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Go to an emergency department if you have an erection lasting four hours, especially if the shaft is rigid or painful.

    Seek emergency help sooner if pain is severe, the erection is becoming more rigid, or you have sickle cell disease and the episode is not settling.

    Follow any emergency plan already provided by your sickle cell or urology team, but do not let home measures delay assessment.

    Call emergency services if the injury is accompanied by heavy bleeding, fainting, severe swelling, difficulty passing urine, or other signs of serious trauma.

    Repeated short episodes are not necessarily emergencies each time, but they can warn of a future prolonged episode.

    A specialist can help you make a clear plan for when to seek emergency care.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Do not wait for it to go away during travel, sleep, or sexual activity.

    An erection after a major pelvic or genital injury also needs prompt medical assessment.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange routine medical follow-up if:

    • You have repeated unwanted erections that settle within four hours
    • An episode ended but pain, swelling, or bruising continues
    • Your erections have changed after treatment
    • You think a prescribed medicine may be contributing

Every sign above is quoted from the sofidex article on Priapism. If you are not sure, err upward — it is always reasonable to be checked.