I,ve been pumping frequently for almost 2 years. Maybe that's not long term enough, but I've not noticed a purple color or a cold feel.

Are the risks of 'priapism' over-stated? Has anyone ever needed a trip to the ER with the dreaded 'if you should have an erection for more than 4 hours, ...'?

Pump erections aren't really erect. Engorged, yes; but not able to stand up at the right angle. So its firm enough for penetration, with a cock ring, but prone to falling out. I pump mainly for therapy rather than intercourse.