Getting the diagnosis of priapism wrong; when not to aspirate. (23rd June 2022)

• Record Type: Journal Article
• Authors: O'Sullivan, Niall J.; Casey, Rowan G.
• Is Part Of: Andrologia. Volume 54:Number 9(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-06-23
• Subjects: andrology training -- corporal aspiration -- misdiagnosis -- penile prosthesis -- priapism; Andrology -- Periodicals; Infertility, Male -- Periodicals; 616.69
• DOI: 10.1111/and.14505
• Languages: English
• ISSNs: 0303-4569

Abstract

Abstract: Priapism is defined as a full or partial erection lasting greater than 4 h due to a fault in the normal detumescence mechanism of the penis. We describe the case of a confused 73‐year‐old gentleman presenting with painless priapism, a 2 cm non‐tethered lesion in the scrotum and a vague palpable pelvic mass. On the presumption that this was a case of high‐flow non‐ischaemic priapism secondary to pelvic malignancy, the urology registrar attempted corporal body aspiration. Clear fluid was aspirated and the penis became flaccid instantly. A CT scan performed to determine the presence of a pelvic mass, revealed a penile prosthesis and artificial reservoir. While iatrogenic penile prosthesis malfunctions are well established in the literature, a case managed as an acute priapism is yet to be reported. This case teaches us the importance of taking an adequate medical history and clinical examination prior to formulating a diagnosis and administering treatment.