Malignant refractory priapism: An urologist's nightmare

Malignant priapism is described as persistent, nonsexual erections caused by invasion or metastasis from a primary neoplasm. We present two cases of malignant priapism with different etiologies and the respective management strategies. A 75-year-old patient had undergone radical cystectomy for a high-grade bladder tumor 5 months ago and came with priapism. The patient persisted to have partial penile tumescence with low-grade pain even after intervention. Another 66-year-old patient came to emergency with persistent painful priapism who had been diagnosed to have Multiple Myeloma. He required a corporotomy and open drainage as a last resort which finally relieved him of pain but with loss of erection. The treatment needs to be individualized based on the clinical course of the patient.