Priapism secondary to chronic myeloid leukemia: value of initial treatment with cavernous lavage plus adjuvant methoxamine

To report a case of priapism secondary to leukemia, with special reference to the initial treatment in the emergency services. A 53-year-old male with chronic myeloid leukemia presented with prolonged involuntary painful erection of 12 hours' duration. The physical examination and particularly the cavernosal blood gas study, indicated low flow priapism. Punction-lavage of the corpora cavernosa was performed. Because complete response was not achieved with this procedure, adjuvant intracavernous methoxamine was administered. Complete detumescence was achieved after the third dose of methoxamine. There was no recurrence and erectile function was preserved. We underscore the utility of combined cavernous lavage + adjuvant alpha-1 adrenergic agonist as initial therapy in priapism with this special etiology.