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for 3-4 hours but this does not require medical intervention.
When an erection lasts for 4-6 hours and is accompanied
by pain, this is known as priapism (excessive erection) and
requires immediate medical intervention. This is because
the passages inside the male organ where the process of
erection takes place contain delicate blood vessels and mus-
cles that can change irreversibly if the erection continues for
8-12 hours. This can result in a man permanently losing his
potency.

There are two types of prolonged erection. One kind is
a single erection accompanied by severe pain owing to ir-
regularity in the blood supply. This is the more dangerous
type, requiring medical intervention as soon as possible. The
second type is caused by a wound in the area and is less dan-
gerous. It is not accompanied by insufficient blood supply to
the organ and does not cause severe pain. It is caused by a
stoppage between the arteries and veins in the organ but this
type also requires medical intervention.

Reasons for prolonged erection can include wounds in
the area of the pelvic girdle [this leads to the less painful
and less dangerous type of prolonged erection] or various
diseases or treatments etc.

Treatment of prolonged erection depends on which type
of erection it is, on its duration and its cause. Prolonged
erection resulting from wounds [the less dangerous type] is
treated by blocking the blood vessels by using a venous stent
or by the surgical closure of the local blood vessels. In such
cases there is no need whatsoever for masturbation to emit
semen.

The situation described in the letter was the more dan-
gerous type of prolonged erection, which requires swift
treatment. The faster it is treated the greater the chance of
immediate success and the less likely will be the need for
complicated treatments. The first concern is that the situa-
tion should not last for longer 3-4 hours and within this time

148 1 Medical-Halachic Responsa of Rav Zilberstein