Which term describes a persistent, usually painful erection lasting more than four hours without stimulation?

• A. Prostatitis
• B. IUD
• C. Nephrolithiasis
• D. Priapism

Answer: (D)

Priapism is the persistence of an erection for more than four hours without sexual stimulation, and it’s usually painful. This condition is a medical emergency because prolonged erection deprives penile tissue of oxygen, risking tissue damage, fibrosis, and permanent erectile dysfunction if not treated quickly. Most cases are ischemic (low-flow), with trapped blood in the corpora cavernosa causing pain and discoloration; treatment focuses on relieving the trapped blood and restoring normal blood flow, often starting with aspiration and medications injected into the penis under supervision. There’s also a non-ischemic (high-flow) form due to unregulated arterial inflow, which is typically less painful but still requires evaluation and management.

The other terms don’t fit the scenario: prostatitis is inflammation of the prostate causing pelvic pain and urinary symptoms; an intrauterine device is a contraceptive placed in the uterus; nephrolithiasis is kidney stones that cause flank or groin pain, not a prolonged erection.