Therapy of priapism in high counting myeloid leukemia--a combined oncological-urological approach. Two case reports

Two cases of leukemic priapism are described. Both patients underwent a combined oncological (antileukemic chemotherapy, cell depletion by leukapheresis) and urological (transglandular cavernosum-spongiosum shunt, heparin lavage of the corpora cavernosa) therapy. Cytologically necrobiotic tumor cells could be identified in the corpus cavernosum aspirates causing blood stasis in the corpora cavernosa initiating priapism. Only sufficient venous outflow by additional transglandular cavernosum-spongiosum shunt completed therapy, effected a rapid detumescence and led to subsequent ability of erection and coitus. This suggests the necessity of additive surgical treatment in every patient suffering from leukemia and priapism, if spontaneous detumescence under chemotherapy is not obvious.