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Ischemic priapism caused by self intracavernous injection of tadalafil

Naoki Wada, T. Hatakeyama, H. Takagi, Ryoken Tsunekawa, Shin Kobayashi, M. Nagabuchi, Takeya Kitta, H. Kakizaki

IJU Case Reports, 2024

2 citations

Abstract

INTRODUCTION: We present a case of ischemic priapism caused by self intracavernous injection of tadalafil.

CASE PRESENTATION: A 77-year-old man developed priapism due to self-injection of tadalafil into the corpus cavernosum. He presented to our hospital 2 days after the development of priapism and severe penile pain. The blood gas analysis of the corpus cavernosum revealed ischemic priapism. At first, we performed percutaneous distal shunt (T-shunt) and cavernosal irrigation, resulting in slight improvement of penile tumescence. Several hours later, penile tumescence and severe pain reappeared. Bilateral proximal (corpora-spongiosal) shunt was performed under anesthesia again. Penile tumescence was slowly and gradually relieved. His erectile function was declined.

CONCLUSION: We experienced a case of priapism due to self intracavernous administration of tadalafil who needed a proximal shunt to relieve the severe penile pain. This case report may serve as a warning for physicians and patients not to use phosphodiesterase 5 inhibitor inappropriately.

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