A man suffered a nine-day erection after a very minor accident involving his moped. We bet you have questions. We had questions.
In a study published in the journal Case Reports in Urology, doctors described the case of a 35-year-old British man who fell off his moped and hit his taint, or his perineum (the part of your body between the genitals and the anus). He developed bruising but had no other significant injuries.
However, he went on to develop an erection that lasted for many days longer than is ideal. Perhaps embarrassed, the man allowed the erection to persist for days before he finally went to a doctor.
"On examination, there was a grade IV erection with a rigid base and shaft," the doctors write in the report. Grade 4 on the Erection Hardness Score (yes, this is a real thing) is the hardest erection on the scale, where the penis is "completely hard and fully rigid".
The man had not suffered pain in his erection, though he did report "mild discomfort on walking", as you'd probably expect.
Doctors took a blood gas analysis of the area and found that it was consistent with high-flow priapism, a prolonged erection caused by unregulated cavernous arterial inflow. Of the two types of priapism, high and low flow, this is the least dangerous type. Low-flow priapism is caused by a blockage, preventing the flow of oxygenated arterial blood from reaching erectile tissue in the penis. This type is often painful and requires urgent treatment, as if enough oxygen doesn't reach the tissue in the penis it can begin to die off, leaving permanent damage.
High-flow priapism, the type this man developed, is a lot rarer and usually the result of blunt trauma. The doctors performed an ultrasound and CT angiogram to determine the cause, and found damage to the cavernosal artery, causing "unregulated pooling of blood within the sinusoidal space propagating a nonischemic erection due to the continuous supply of oxygenated blood".
Essentially, the injury he'd sustained falling off his moped was causing too much oxygenated blood to rush into his penis.
Generally, high-flow priapism is treated conservatively through ice packs, mechanical decompression on the affected blood vessels, or just holding the patient for observation until it desists, the doctors explain in the case study. In this case, however, the doctors decided "timely intervention [needed] to be considered to avoid the potential risk of erectile dysfunction in the long term."
In order to avoid potential erectile dysfunction later on, the doctors opted to artificially restrict blood flow into the penis using a catheter to insert a gel-like foam and a microcoil. He was sent home to recover, and a year on he is back to normal.
"Self-reported erectile function has slowly improved over the course of twelve months," the doctors reported. "Long-term follow-up has shown return to normal erectile function twelve months following the injury."