A 32-year-old African American man experienced an erection that lasted as long as 12 hours probably due to frequent use of cannabis, according to a team of doctors at Coliseum Medical Centers in Macon, Georgia.
The doctors said it is the “first known case of cannabis-associated priapism in a patient where all other known causes of priapism have been excluded.”
Priapism is a medical emergency characterized by a prolonged and painful erection that may last more than four hours. If left untreated, priapism could permanently damage the penile organ.
This is the first time that doctors have recorded a rare instance in which priapism has been believed to be caused by frequent use of marijuana.
The doctors who treated the man wrote about this rare case in the journal of Cannabis Research.
The man was admitted to the medical center after complaining of an erection that lasted for nearly 12 hours, which was not related to sexual activity.
The man again visited the ER two weeks later with the same complaint but this time the erection lasted up to six hours. He was given an injection of phenylephrine, a potent vasoconstrictor, which helped subside the erection.
He told doctors that he smoked marijuana “several nights” per week for the last six months, including “within the two hours period prior to each presenting episode of priapism.”
In those six months, he said he had a prolonged erection at least four times, which subsided on their own. He also told his doctors that he started using marijuana at the age of 16 and had several episodes of priapism that subsided without any medical attention.
The man explained that he stopped using marijuana in his twenties and had never had priapism in that period. He also said he never took any prescription or over-the-counter medicines.
The doctors wrote, “On physical exam, the patient was mildly hypertensive with an erect, swollen, and tender penis.”
“A repeat needle aspiration with (1000 mcg total) of phenylephrine was completed, again resulting in successful detumescence,” they added. “A urine drug screen was consistent with cannabis use without other drug use.”
They continued, “A complete blood count revealed no anemia and a normal mean corpuscular volume. The patient was again referred to urology and internal medicine on an outpatient basis for further workup; however, he was lost to follow-up in this period.”
“He had no medical history other than mild hypertension, he took no medications, and used only cannabis, supported by his urinary drug screen,” according to the doctors. “Further, his history exhibited a convincing correlation between his cannabis use and his episodes of recurrent priapism.”
The doctors could not explain why marijuana caused priapism. However, they believe that marijuana may contain a chemical that might have switched off brain signals that bring back the penis to normal state after an erection.
They also said the effect of marijuana on the blood flow could also be one of the reasons. When you smoke cannabis, your blood vessels tend to dilate. The researchers said, “This, too, could potentiate the unrelenting erection notable in priapism.”
