Pressure surely is part of megallophallus.
It’s proven that tissue under constant load will expand.
Be it low intensity for long time or high intensity for short time.
In a priapism there is constant pressure on the CC’s. They will give in. If too much you get faulty tissue.
There is a good case that hypoxia is part of it too.
But surely not the single cause.
Just think about it…
Choke off your flaccid dick and creat a hypoxic environment. You really think out of nowhere your dick grows thx to hypoxia??
Just do clamping and push the boundaries. You will get a similar priapism effect.
You can clamp for hours while allowing some inflow (kegels) and stopping the outflow compared a bit more. The CC outflow is best regulated by having the clamp tight pressuring at the top side into the base.
Shutting it completely off for some minutes will produce low hypoxia, FAST.
I couldn’t manage to do that more than some minutes. Huge discoloration and the creeping feeling of a dead penis.
But if you manage to get some little fresh blood in while letting out less blood it’s possible to do that for quiet some time and maybe even 4+ hours.
If you combine it with an ADC that maintains a low oxygen environment it will probably intensify the effect.
…Voila a simulated priapism…
But did anyone ever have the stamina and mental power to do that?