# I'm afraid to ask but: How do they treat an erection that lasts for more than 4 hours?
**URL:** https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211
**Category:** Factual Questions
**Created:** [November 28, 2010, 10:22pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211 "2010-11-28T22:22:10Z")
**Posts on this page:** 20
**Page:** 1
### Author:  [@Khadaji](https://boards.straightdope.com/u/Khadaji)
#### Post date: [November 28, 2010, 10:22pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/1 "2010-11-28T22:22:10Z")
So I’m watching NFL and I see lots of adverts for Viagra - and one thing that is always stated is that you should see an doctor if your erection lasts more than 4 hours.
I’m sure I don’t want to know but - so what \*do \*they do?
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### Author:  [@LeidenFrost](https://boards.straightdope.com/u/LeidenFrost)
#### Post date: [November 28, 2010, 10:24pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/2 "2010-11-28T22:24:27Z")
If they really have to, I think they start by draining blood from the penile vein.
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### Author:  [@Harmonious\_Discord](https://boards.straightdope.com/u/Harmonious_Discord)
#### Post date: [November 28, 2010, 10:25pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/3 "2010-11-28T22:25:08Z")
Drain the blood with a needle.
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### Author:  [@carnut](https://boards.straightdope.com/u/carnut)
#### Post date: [November 28, 2010, 10:25pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/4 "2010-11-28T22:25:28Z")
Uhh, hand job? Bucket o’ ice? Good question Khadaji.
Of course, if they guy is only age 14, four hours might be normal. 😉
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### Author:  [@Khadaji](https://boards.straightdope.com/u/Khadaji)
#### Post date: [November 28, 2010, 10:26pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/5 "2010-11-28T22:26:10Z")
> [@LeidenFrost](#):
>
> If they really have to, I think they start by draining blood from the penile vein.
I \*knew \*I didn’t want to know! 😃
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [November 28, 2010, 10:32pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/6 "2010-11-28T22:32:06Z")
why do i read these things?
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### Author:  [@running\_coach](https://boards.straightdope.com/u/running_coach)
#### Post date: [November 28, 2010, 10:40pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/7 "2010-11-28T22:40:06Z")
> [@LeidenFrost](#):
>
> If they really have to, I think they start by draining blood from the penile vein.
> [@Harmonious\_Discord](#):
>
> Drain the blood with a needle.
I am so glad I’m not virile. 😉
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### Author:  [@bleibtreu](https://boards.straightdope.com/u/bleibtreu)
#### Post date: [November 28, 2010, 10:54pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/8 "2010-11-28T22:54:24Z")
It depends on what’s causing it, and specifically whether you have ischemic priapism (bad news) or nonischemic priapism (might be able to just wait it out).
The Mayo Clinic’s explanation of treatments is here:
> **[A prolonged erection of the penis-Priapism - Symptoms & causes - Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/priapism/symptoms-causes/syc-20352005)**
>
> \Understand the symptoms, possible causes and treatment of prolonged erection of the penis, including when to seek emergency care.\
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### Author:  [@WhyNot](https://boards.straightdope.com/u/WhyNot)
#### Post date: [November 28, 2010, 11:00pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/9 "2010-11-28T23:00:27Z")
> [@LeidenFrost](#):
>
> If they really have to, I think they start by draining blood from the penile vein.
I think you mean the corpus cavernosum, the spongy erectile tissue that fills with blood to produce an erection. That is a treatment, about in the middle of the list of things they’re likely to try.
First of all, there are two kinds of priaprism - ones where the blood can’t get out (vaso-occlusive or “low flow”) and ones where the blood won’t stop coming in (arterial, or “high flow”) Obviously, they’re treated differently, if the docs can figure out which yours is.
High flow are often just observed to see what happens. This kind of priaprism isn’t so likely to cause lasting injury, and often time is all that’s needed to reduce the erection. Compression therapy (which is just about what it sounds like) can often resolve high flow priaprism, especially in little boys (yes, it happens). Sometimes, there’s a fistula (opening) where it shouldn’t be that’s causing the blood to keep coming into the penis, and a simple procedure is needed to close the fistula, either with angiography or surgical incision.
Low flow priaprism is more common, more dangerous, and the one the ED drugs may cause. With low flow priaprism, the least invasive interventions are ice to the groin and perineum, pressure on the perineum and having the man walk up some stairs. These can all be tried at home before the 4 hours are up, by the way.
If four hours pass, an ER visit really is called for. Low flow priaprism can cause pretty hellacious long term effects on your penis. If ice, pressure and stairs don’t do it, they’ll probably give you one or more drugs which may make the erection go away - terbutaline taken orally resolves about one third of the cases. Some docs will use oral pseudoephedrine, but I’m not sure how widely that’s accepted yet. If that doesn’t work within 30 minutes, an injection of an alpha-adrenergic blocker will be attempted. Third line of intervention is the aforementioned aspiration of the blood in the corpus carvernosum with a needle. If this doesn’t work they’ll also inject alpha-adrenegeric blockers or methyline blue into the cavernosum itself
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### Author:  [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)
#### Post date: [November 28, 2010, 11:13pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/10 "2010-11-28T23:13:26Z")
Need answer fast? 😉
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### Author:  [@Washoe](https://boards.straightdope.com/u/Washoe)
#### Post date: [November 28, 2010, 11:14pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/11 "2010-11-28T23:14:09Z")
> [@WhyNot](#):
>
> Some docs will use oral pseudoephedrine, but I’m not sure how widely that’s accepted yet.
I’ve often wondered about that. If that damned boner simply won’t go away, why can’t you just try pseudo first and see what happens before you make that embarrassing trip to the ER?
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### Author:  [@running\_coach](https://boards.straightdope.com/u/running_coach)
#### Post date: [November 28, 2010, 11:21pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/12 "2010-11-28T23:21:23Z")
> [@ElvisL1ves](#):
>
> Need answer fast? 😉
He’s got a few hours. 😃
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### Author:  [@WhyNot](https://boards.straightdope.com/u/WhyNot)
#### Post date: [November 28, 2010, 11:27pm UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/13 "2010-11-28T23:27:44Z")
> [@Washoe](#):
>
> I’ve often wondered about that. If that damned boner simply won’t go away, why can’t you just try pseudo first and see what happens before you make that embarrassing trip to the ER?
Since it’s OTC, if you don’t have any allergies or weird reactions to it or drugs you can’t take with it, sure, of course you can try it at home. I’d try it before hour 3 though, and if it hasn’t worked in 30 minutes, it’s not going to.
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### Author:  [@Chronos](https://boards.straightdope.com/u/Chronos)
#### Post date: [November 29, 2010, 12:09am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/14 "2010-11-29T00:09:17Z")
Quoth **Khadaji** :
> [@](#):
>
> I knew I didn’t want to know!
Never, ever look up information on Mayan blood rituals.
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### Author:  [@panache45](https://boards.straightdope.com/u/panache45)
#### Post date: [November 29, 2010, 12:22am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/15 "2010-11-29T00:22:56Z")
Leeches?
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### Author:  [@Freudian\_Slit](https://boards.straightdope.com/u/Freudian_Slit)
#### Post date: [November 29, 2010, 12:25am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/16 "2010-11-29T00:25:05Z")
> [@Washoe](#):
>
> I’ve often wondered about that. If that damned boner simply won’t go away, why can’t you just try pseudo first and see what happens before you make that embarrassing trip to the ER?
You try going to the drug store while pitching a tent! :eek:
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### Author:  [@fumster](https://boards.straightdope.com/u/fumster)
#### Post date: [November 29, 2010, 1:03am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/17 "2010-11-29T01:03:44Z")
Guy walks into a Dr’s office and asks the receptionist for an appt. She explains the Dr is busy and asks what his problem is. He says, “I have a large erection that won’t go down”. "Oh’, she says, “I’ll see if I can squeeze you in”.
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### Author:  [@ExcitedIdiot](https://boards.straightdope.com/u/ExcitedIdiot)
#### Post date: [November 29, 2010, 3:45am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/18 "2010-11-29T03:45:34Z")
> [@Chronos](#):
>
> Never, ever look up information on Mayan blood rituals.
Maybe it’s my defiant personality, but whenever someone says don’t look at something, I have to.
Thanks:smack:
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### Author:  [@Derleth](https://boards.straightdope.com/u/Derleth)
#### Post date: [November 29, 2010, 3:52am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/19 "2010-11-29T03:52:02Z")
> [@panache45](#):
>
> Leeches?
You lecherous old sot!
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### Author:  [@Chronos](https://boards.straightdope.com/u/Chronos)
#### Post date: [November 29, 2010, 4:01am UTC](https://boards.straightdope.com/t/im-afraid-to-ask-but-how-do-they-treat-an-erection-that-lasts-for-more-than-4-hours/562211/20 "2010-11-29T04:01:42Z")
> [@](#):
>
> Maybe it’s my defiant personality, but whenever someone says don’t look at something, I have to.
>
> Thanks
Of course, those of us who are cruel enough to tell people not to look at something do so because we know there are bound to be people perverse enough to do so anyway.
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