Ischemic priapism secondary to COVID-19 infection versus Anticoagulant-induced

Abstract

Priapism is considered a rare disorder, and even rarer when it occurs as a complication of COVID-19. To the best of our knowledge, there are only five studies that reported priapism as a complication of COVID-19. Here we report a 66-year-old male infected with COVID-19 and presented with neglected priapism for three days. On local examination, penile erection was noticed associated with black areas on the glans penis extending to mid penile shaft denoting penile gangrene. A clear line of demarcation was noticed at mid penile shaft. The penile duplex was performed and showed no blood flow in both cavernosal arteries.

Penile aspiration was performed and the cavernosal blood sample showed criteria of ischemic priapism. Given the presence of penile gangrene extending to the midshaft of the penis and the bad general condition, the decision was to perform partial penectomy and suprapubic tube placement. We recommend the establishment of a guideline for the diagnosis and prevention of thrombotic diseases in patients with COVID-19 infection as there is increasingly growing evidence of COVID-19-related thrombotic manifestations.