Four-hour erection can cause permanent erectile dysfunction – Don

A Professor of Surgery at the University of Lagos, Prof. Kehinde Tijani, has stated that a persistent penile erection lasting more than four hours is a medical emergency and can cause permanent erectile dysfunction.

In his inaugural lecture titled ‘Man’s Reproductive System: Its Manufacturing Errors, Equipment Failure, and Failed Deliveries,’ Tijani stressed the importance of seeking immediate specialist care for surgical intervention.

He warned that a delay of more than 24 hours could result in permanent erectile dysfunction.

He counselled that children with perceived abnormalities in their sex organs should see a specialist as soon as possible.

Tijani added that in most cases the abnormalities could be sorted out before the age of gender self-awareness.

He also suggested that health workers dealing with newborns and infants should be trained on how to examine and identify abnormalities of the external genitalia.

Speaking at the event, Prof. Kehinde Tijani noted that his inaugural lecture was the third in a series from the Urology unit at the University of Lagos, with the previous one delivered 27 years ago.

He shared that his interest in urology was sparked by the urinary problems experienced by his grandfather. Additionally, during his student days, urology patients were predominantly elderly men suffering from issues related to urethral catheters.

He recommended that “Fracture of the penis is real and not rare. Couples should be wary of sexual positions that significantly increase the risk.

“Persistent penile erection lasting more than four hours is an absolute emergency and the patient must seek specialist care for surgical intervention as soon as possible. A delay of more than 24 hours can lead to permanent erectile dysfunction.

“Males account for at least 50 per cent of cases in couples with infertility. For couples experiencing infertility, the man should be evaluated first by doing a semen analysis. If the test is normal, emphasis should shift to the partner.”

He maintained that the government and stakeholders should establish facilities for the MRI-TRUS fusion prostate biopsy as this would significantly increase the chances of early diagnosis of prostate cancer.

Tijani also called for immunisation of boys against the Mumps virus before puberty.

Kehinde’s comprehensive analysis encompassed topics such as hypospadias, erectile dysfunction, premature ejaculation, penile fracture, priapism, and male infertility, providing attendees with valuable insights and understanding of these critical health concerns.

He said “Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis and this is the most common urological congenital anomaly in male children. Hypospadias incidence is about one in 150-300 live births which usually consists of components like abnormal spraying during urination, opening of the urethra at a location other than the penis, downward curve of the penis and hooded appearance of the penis.”

“Like every machinery and vehicle, accidents can occur to the male reproductive organ and this occurs when the penis is at rest or erect. We conducted a study on the pattern and treatment outcome of genitourinary injuries in Lagos. The most common age group was 20-29 years.”

“In the last 20 years, eleven cases of injuries have been confirmed. Eight cases were from machinery injuries, usually a fan belt of a grinding machine, one was from self-gratification causing penile strangulation, one from a jealous housewife and one from a neighbour who put firecrackers in the trousers of a man found with another man’s wife.”

He said, “Priapism is indeed a urological emergency with a very high risk of permanent disability. It is defined as a purposeless, penile erection lasting more than four-hours. It is usually painful and occurs without sexual stimulation and is unrelieved by ejaculation.”

“There are two types of priapism, ischaemic priapism and non-ischaemic priapism. The most dangerous form of it is ischaemic priapism because it reduces blood flow to the penis. This is most common and accounts for over 95 per cent of cases. The treatment involves the rapid decompression of the penis by expelling the toxic blood and creating a path for adequate blood flow.”

He advised that if not treated, ischaemic priapism ultimately could lead to permanent erectile dysfunction and it can occur in both children and adults.

The Vice-Chancellor, UNILAG, Prof. Folasade Ogunsola congratulated the entire members of the Tijani family and thanked them for being at the side of Prof. Kehinde Tijani.

She said, “One such manufacturing error called hypospadias is present at birth and is the most common abnormality in the male reproductive system, and it is very difficult to treat surgically due to the high risk of complications. But the professor developed a novel technique to address this difficult problem, which has now been quoted in the standard textbook of reconstructive urology for dealing with a difficult issue, especially because it eliminates a dreaded complication called diverticulum in those patients.”

“One other important contribution to his work was to debunk the general belief that infections were the most common causes of urethral stricture disease. What he showed based on his findings, he showed that trauma was now the most common cause. Based on this finding, he developed another technique for the repair of resistance. This work has been quoted in the European Association of Urological Guidelines.”

She explained that the Tijani showed the two most common abnormalities found in men with low sperm count and infertility were the small testes and varicose cells, many of which were due to mumps.

At the lecture, the VC told Kehinde, “Now that you have successfully paid your academic debt to the University of Lagos with today’s excellent and very interesting inaugural lecture. On behalf of the Senate, you are hereby discharged and acquitted. I therefore welcome you to the committee of professors who have paid their dues.”