Urethrocutaneous fistula post-Al-Ghorab shunt

Priapism is a rare event that may be induced by clinical conditions and medications. Ischemic priapism (IP) is a compartment syndrome of the penis, and it constitutes a medical emergency that may cause significant morbidity on the erectile function in particular. We report a case of a 30-year-old male in his fourth episode of priapism. The aspiration and washing of the corpora cavernosa with saline solution were performed, followed by washing with adrenaline solution without resolution of the condition. Treatment was followed by the performance of the Al-Ghorab shunt procedure with dorsal incision of the glans. During follow-up, an area of necrosis distal to the incision was detected, and after the catheter removal on postoperative day 14, the patient developed a glandular dorsal urethrocutaneous fistula and meatal stenosis. The meatal stenosis was corrected by Johanson urethroplasty with a neo-meatus at the coronal sulcus, along with resection and debridement of the fistula tract and a three-layer closure.