Trauma and Erectile Dysfunction

Erectile dysfunction can be a common consequence of traumatic injuries, particularly pelvic, perineal or vertebral injuries. Generally the underling cause is damage to genital nerve function, and/or decreased penile bloodflow due to vascular injuries.

In some cases however trauma may not be due to injuries like falls or direct blow to the genital region. It can also be a consequence of treatment used to treat pelvic and perineal disorders, especially with surgeries for bladder, colorectal and prostate cancers, such as radical prostatectomy.

Bicycle-Riding – Low Level Trauma?

World champion cyclist Lance Armstrong has recently opened up about his experiences with erectile dysfunction. And he’s not alone. In fact Dr Irwin Goldstein, urologist and editor-in-chief of The Journal of Sexual Medicine, has gone so far as to say:

“There are two kinds of cyclists: those who are impotent and those who will be.”

It’s theorised that too much time spent on a bike seat can cause slow, low-level trauma to perineal nerves, resulting in numbness in the short term and possibly erectile dysfunction long term.

Happy news for cycle fans though: it’s believed the key culprit may be the style of bike seat, and some new nose-less seats are now being designed to reduce perineal impact.

Treatment for Trauma-Caused ED

While in the past experts have recommended allowing up to 18-24mths recovery for men affected by post-trauma erectile dysfunction, modern research suggest it may be a case of “use it or lose it”. In other words, if you’re experiencing erectile dysfunction as the result of trauma, the sooner you act the better.

Good news is, there are some great Aussie men’s health specialists available to help. Sexual Health Australia in particular is a good place to start. Don’t delay! The sooner you start, the better your chances and the sooner you’ll be enjoying an active, healthy love life again.

Trauma-Caused Priapism Erectile Dysfunction

Not all post-trauma erectile dysfunctions involve an inability to gain a sufficient erection, however. It is possible to experience priapism. A priapism is where an erection will not go down, and in some cases can be painful. There are two forms of priapism, low-flow and high-flow:

  • Low-Flow Priapism. This is where blood becomes trapped in the erection chambers. This is the most common type of priapism post-trauma. It can occur in healthy men without a known cause however. Low-flow priapism is more likely to be painful.
  • High-Flow Priapism. High-flow priapism is less common and less likely to be painful. It results from a ruptured artery due to direct genital trauma, preventing proper bloodflow.


Priapism can also be caused factors other than trauma. It is a possible side-effect of erection drugs such as Viagra, carbon monoxide poisoning, illicit drug use (in particular marijuana and cocaine), as well as some spider bites. Sickle cell anemia is also commonly associated with priapisms: it’s estimated that around 42% of adult men with sickle cell will eventually be affected by some degree of priapism.

Priapism Treatment

Treatment for priapism depends a little on the duration and severity of the priapism. With all treatment however the objective is not only to cause the erection to resolve, but also preserve future erectile function as best as possible. Treatments may include:

Ice Packs. Ice applied to the penis and/or perineum may in some cases be all that’s needed to reduce swelling. This is less likely with more severe priapisms however.

Aspiration. After anaesthetising the genital region, doctors insert a fine needle into the penis’ chambers and drain blood to reduced pressure and swelling.

Intracavernous Injection. Similar to Aspiration above, only in this case instead of removing blood a drug is injected, which causes veins to narrow, reducing penile bloodflow and hopefully allowing swelling to subside. This is only used in cases of low-flow priapism, and is less common in cases of trauma.

Surgical Shunt. Also used for low-flow priapism, a shunt (small metal passageway) is surgically inserted into penile blood chambers to divert bloodflow and allow circulation to return to normal.

Surgical Ligation. Used in high-flow priapism cases where the artery rupture is significant, doctors will ligate (tie off) the artery below the rupture to restore normal bloodflow.

NB.

It should go without saying, but please do not attempt any of these priapism treatments yourself, or with assistance of a non-medically trained partner. Priapism can be serious, and both the condition and treatments may potentially cause further damage and trauma. If you believe you may be experiencing priapism seek emergency medical assistance immediately.