Priapism secondary to leukemia: effective management with prompt leukapheresis

Priapism is a urological emergency; without prompt treatment the corpora cavernosa undergoes necrosis and fibrosis that may result in erectile dysfunction. Treatment initially involves conservative measures, such as corporeal aspiration and irrigation with saline or dilute phenylephrine. If this fails, embolization or surgical shunting is usually required. Hyperviscosity resulting from leukemia is a rare cause of priapism. We report a case of a 19-year-old man with an 18-hour history of priapism secondary to undiagnosed chronic myeloid leukaemia. We discuss the method of leukapheresis (mechanical white cell depletion) to reduce viscosity and achieve detumescence after failed aspiration.