Abstract

Priapism is defined as a penile erection that persists more 4 hours or longer and is unrelated to sexual activity. The three main subtypes are low flow (ischemic), high flow (nonischemic) and stuttering (intermittent or recurrent) priapism. Alpha-1 antagonistic activities of some antipsychotics, especially chlorpromazine, have been reported to be responsible for development of low-flow priapism. Chlorpromazine has the greatest alpha-adrenergic affinity among the conventional antipsychotic agents and the most frequently reported to be associated with priapism. We report a case of priapism after a first single dose of chlorpromazine (Neurazine #xAE; 100 mg tablet, Misr Co. For Phramind-Egypt). The case was presented first by neglected low-flow priapism that had been converted to high-flow priapism due to injury of a branch of the cavernosal artery, during aspiration and irrigation treatment procedure, proved by blood gas testing of the aspirated penile blood, penile color duplex Doppler ultrasonography and selective left internal pudendal arteriogram. This conversion is an uncommon complication of such procedure.