Cocaine intoxication resulting in ischemic priapism:

a case report and literature review

Abstract

 This work presents a case report on ischemic priapism in a 33-year-old patient, an illicit substance user, who started experiencing priapism hours after using cocaine. A dorsal nerve block was performed with 2% lidocaine and two punctures were performed in each of the cavernous sinuses, draining approximately 54 mL of blood. Afterwards, intracavernous etilefrine was administered. The patient was kept under observation, remaining with priapism for approximately 48 hours, with a poor response to intracavernous medications. Blood gas analysis of the corpus cavernosum and penile ultrasound with Doppler confirmed the diagnosis of ischemic priapism, and the patient underwent surgical treatment, with an Al- Ghorab distal penile gland cavernous shunt. The surgery was uneventful, and the patient evolved well, with relief from pain and significant improvement in penile edema. A literary review was also carried out by searching the keywords “ischemic priapism”, “case report” and “cocaine abuse” on the Google Scholar and PubMed® platforms. After this analysis, it was possible to identify cocaine as responsible for the ischemic priapism in a substance user patient.