High-flow priapism without a history of trauma: A case report

Abstract

Background: Priapism is a partial or total erection which lasts more than 4 hours that occurs in the absence of sexual stimulation. It has an incidence rate of 1.5 per 100,000 people. It is classified as ischemic (low-flow) or non-ischemic (high-flow). Non-ischemic priapism is an atypical presentation characterized by a non-rigid erection without pain, and it is frequently associated with trauma. Our objective is to present this clinical case to highlight the importance of correctly classifying priapism types to provide appropriate treatment and avoid complications.

Clinic case: A 37-year-old male with no history of chronic degenerative diseases. Patient’s condition began with a morning erection followed by sexual activity. Patient came to the Emergency Room 5 days later since the erection persisted, which he reported was pain-free. He denied recent trauma or the use of erectile stimulants. High-flow priapism was diagnosed via Doppler ultrasound. Selective angioembolization was performed, achieving an immediate detumescence of 40%.

Conclusion: Corporal blood gas testing is essential in the initial evaluation of any patient presenting with priapism. For high-flow priapism, conservative management should first be attempted; if priapism persists, embolization of the affected pudendal artery can be offered.