Prolonged Erection After ICI? The 4 Hours Rule, Explained.

If you are using injections for your erections, there is a number that I want you to have always in your mind and it is 4 hours. If you have an erection after an injection and if this erection lasts 4 hours or more, go immediately to A&E. Injections therapy work very well for a lot of men, it is a prescription-only medicine.

It is generally safe when the dose has been decided with the clinician, when the instructions have been given accurately. However, occasionally the erection simply does not go away. When the erection lasts more than four hours, it may be a priapism, and that is one of the urological emergencies.

How often does this happen? When we talk about alprostadil, the information leaflet states that four out of a hundred men get an erection that lasts between four to six hours and about four out of a thousand men get an erection that lasts six or more hours.

So because your own risk depends precisely on the product that your clinician prescribed for you, is best if you ask them what is the risk and what is the product that you have been given.

Some conditions make the risk more likely to happen, for example using more than the agreed dose or injecting twice in one day or combining this injection with other commonly used medications like the sildenafil, tadalafil, vardenafil, the typical tablets used to have an easier erection. And we need to make sure that we know the higher risk in having side effects, for example prolonged erection, when the injection is used in context with recreational drugs. So it's best to avoid any DIY combination.

Why this rush? Why four hours? The blood that is trapped in the penis runs out of oxygen and toxins start to accumulate and the tissue starts to suffer. However, if you are in a situation where you are already beyond those numbers, still it is worth to go immediately to the hospital.

Unless your own clinic has given you a written plan, do not try to find your way out of it, looking on internet, taking drugs or taking different type of injection, it's best if you go to the emergency department and you simply tell them I have used an injection therapy for erectile dysfunction and I have an erection lasting for five, six or seven hours.

Also tell them exactly what is the product that you have taken and if there were context of using tablets or using recreational drugs etc. They are there to treat you and not to judge you.

If you want to know what's going to happen once you have reached the hospital, the very first approach to this type of problem is usually attempting another type of injection that is a sort of antidote, a medicine called phenylephrine injected inside the penis, which makes the blood vessels squeeze the blood out of the penis and offering a chance of detumescence, that means losing the erection.

The attempt will be done to drain the unoxygenated blood that has been trapped in the penis with a needle. I know that it sounds a bit rough but this is normally done after a local anaesthetic so it's normally reasonably comfortable.

Sometimes if this is not enough there is the need of doing some more complex procedure that are called shunts and on occasion these may require a local anaesthetic or a general anaesthetic.

Four hours. Don't forget this number. Then go to the hospital. If you have questions about your own injection speak immediately to the clinic or the clinician that have prescribed them and if you have any comment on this video please write it down in the comment section and don't forget to subscribe to this channel if you found this useful.