Health Care Mall: Priapism
A few case reports have described priapism following cocaine administration. In two men the cocaine had been applied to the glans penis to take advantage of its local anaesthetic effects in order to prolong sexual intercourse. In another, the route of administration was intranasal.
Hypotheses to explain the priapism include profound penile vasodilatation secondary to stimulation of serotonin release from platelets, or local depletion of noradrenaline preventing detumescence. The latter suggestion is based on the fact that noradrenaline causes contraction of penile arterioles, which reduces bloodflow to the penis.