Medicine in Africa Can Be Fun

Medicine in rural Zambia, sometimes, can be fun. I had a young gentleman in the hospital recently. He mentioned that he was having concerns about his penis. I told him that I would need to examine it just to be sure. So, he undid his trousers for me. To my surprise, the young fellow was fully erect! In medical school, we are taught that when you are examining a male and he has or gets an erection, you should stop the exam and tell the patient that you'll come back later when his erection has subsided. Not in this case. I found out that he had ‘priapism’.

Priapism is an emergency medical condition where there is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.

The causes of priapism can be many. Beside various medical conditions and illegal and legal drugs which are the common causes, the use of certain roots and herbs for performance enhancement is a common practice in this part of rural Africa. (Viagra is quite out of sight, still).
Photo courtesy: Gunilla Elam, Science photo library

Apparently, this young guy was visiting his fiancé the night before, who was staying some distance away in the neighbouring village. A storm came up while he was visiting her and she insisted that he stay the night in her single bedroom house. According to him, during the night, she crawled into bed beside him. Fireworks ensued, as you can imagine.

A good twelve hours had already gone wasted since the calculated time of the onset. So I had to attend to him straightaway. But mind you, I am neither a surgeon nor a urologist and never before had I seen and treated the condition. Quickly I went through my surgical references, anatomy texts and finally came up with information and a resolve strong enough to tackle the problem on my own. Whatever the treatment options be, the goal of all treatment is to make the erection go away and preserve future erectile function. And I decided to apply the Aspiration method. Under the cover of short acting anaesthesia, I sterilised the organ with antiseptic solutions a number of times and finally introduced a 20G canula exactly on the left corpus cavernosa. Through it I drained and aspirated about 150 millilitres of the trapped blood. It worked perfectly. The organ which pointed 12 O’clock before had finally given up and came down to its normal 6 O’clock position. It was a great relief for my patient. Oh, the fun we doctors have!