Pharmacologically-induced Recreational Priapism: Case Report and Review

Abstract

Introduction: Priapism, a time-sensitive urologic emergency, is associated with hematologic disorders, malignancies, trauma, pharmaceuticals, and recreational drugs. Case Report: A 51-year-old male presented with 36 hours of priapism after recreational use of nonprescribed pharmaceuticals including an oral phosphodiesterase inhibitor and intracorporally injected erectile medications, together with unspecified quantities of cocaine and alcohol. Venous blood gas confirmed ischemic priapism. Detumescence was achieved with intracavernosal phenylephrine injection, aspiration, and irrigation. Conclusion: This case highlights the risk that recreational use of vasoactive medications by patients who seek to prolong sexual activity may lead to delayed presentation for ischemic priapism.

Refractory ischemic priapism following the concomitant use of Viagra and Cocaine: A case report

“…Currently, there is limited research on the prevalence of ischemic priapism and patient outcomes following concomitant usage of PDEI5s and cocaine. However, a similar was reported by Grace Kunas et al in 2020 which involved a 51-year-old-male suffering from 36 hours of ischemic priapism following a combination of an 'oral phosphodiesterase inhibitor and intracorporally injected erectile medications, together with some unspecified quantities of cocaine and alcohol' (8). In contrast to our case, this case of ischemic priapism resolved after a corporal injection of phenylephrine and irrigation with sterile saline, as the patient reported normal erections on day 11 of follow-up (8).…”

“…However, a similar was reported by Grace Kunas et al in 2020 which involved a 51-year-old-male suffering from 36 hours of ischemic priapism following a combination of an 'oral phosphodiesterase inhibitor and intracorporally injected erectile medications, together with some unspecified quantities of cocaine and alcohol' (8). In contrast to our case, this case of ischemic priapism resolved after a corporal injection of phenylephrine and irrigation with sterile saline, as the patient reported normal erections on day 11 of follow-up (8). Nevertheless, clinicals should be aware that both prescribed medications and recreational drugs may lead to refractory priapism.…”