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Urology/priapism damage symptoms


QUESTION: Hello Doctor Stephen,
I would first need to thank you for such supportive services.
I been suffering ED for quite sometime,sometimes i still can perform sexual intercourse but it needs to be very excited.
My doctor describe me Viagra 50mg which work pretty well. I just had an incident that worrying me as one night i took the viagra and made love twice in 3 hours then i went to sleep and i woke 2 hours later with a very hard on that did not go till i masturbate.
I used to be able to stay hard for sometime even without viagra, only i suffer to continue till ejactuate, but since that night i feel i lose my erection faster than it used to be, i still can get hard but it does not last as it used to be without any medication ( viagra), do you see any symtpoms that i may suffered sort of priapism that night while i was a sleep and it cause damage that makes me can not stay hard as i used to be ?
If a priapism cause a permenant damage, will i still be able to be hard and lose it quickier or i wont be able to get hard at all ?
My penis physically looks normal and no change i just worry even to use viagra again before i am sure everything is fine
Thanks in advance

ANSWER: Ahmed:

Priapism may cause permanent damage depending on the severity and duration of the priapism.  Since the degree of damage is so variable, it's impossible to predict what will happen in the future.  Most of the time, unless the damage is severe, erection function remains more or less as before but you may need help from Viagra for some time.  You may want to try just 25 mg.

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QUESTION: Thanks Doctor Stephen.
May you allow me to ask if damage has to happen to penis fabric, should not it be from long lasting painful erection ? or can it be painless.
I always believe that body is self defense alerted, so if thing is not painful then it should not be damageable.

Another question please, some days i feel excited for hours , for no reason just like that :) , it does not give me hard on though penis is not in fully flaccid state kind of 40% - 60% hard vary with the position ( sitting - standing - sleeping), will this cause damage too if it last for 7 or 8 hours like this
Appreciate you assistance.

ANSWER: Ahmed:

Since the penis and especially the corpora are designed for prolonged low flow, there may not be much pain although damage could have been done.  So you can't assume no damage was done because there was no pain.  An incomplete erection is not likely to cause problems.

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QUESTION: Many thanks Dr. Stephen.
Please allow me one last question please, I asked my doctor to allow me a penile doppler to verify if any damage as i really feel i lose my erection much fast than it used to be but he strongly disagree, he physically checked my penis and claim that if any scars or damage he should be able to feel something different like lumps or hardness or something but he felt the penis is normal and it is all in my mind !!!
I am not sure, do you agree that damage can be felt by hands if it exist or shall i look for another doctor outside of my medical insurance.

One thing else plz, i could not find any denote area in the site, is there any option i can help to keep such service available.
Thanks alot


I do not agree that a direct physical examination is sufficient.  Damage inside the corpora would not be detectable without further evaluation.  WHile there may be some psychological effects, it is unfair to assume it's all in your mind at this point so I would suggest another opinion from a different urologist.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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