[Priapism in adults. 16 cases]

Priapism is a rare disease, characterized by prolonged, painful and irreducible erection, not resulting in ejaculation. It is an andrological emergency with a poor prognosis, as the risk of impotence is 50% despite appropriate management. Treatment is essentially surgical. The authors report their experience of 16 cases of priapism observed over a 15-year period. The mean age of the patients was 36 years (range: 21 to 56 years). The diagnosis was clinical. The mean time to consultation was 8 days (range: 1-28 days). Priapism was secondary to neuroleptics in 6 cases (37%), chronic myeloid leukaemia in 2 cases, sickle-cell anaemia in one case, radiotherapy in 1 case and the cause remained unknown in 6 cases (37%). Treatment was surgical in every case and consisted of spongiocavernous anastomosis in 11 patients (Winter's procedure in 1 case, Al-Ghorab's procedure in 6 cases and transperineal in 4 cases, with saphenocavernous anastomosis in 5 cases). The overall failure rate of surgical treatment was 37%. The success rate of spongiocavernous fistula was 70% and the authors preferred the Al-Ghorab type of spongiocavernous fistula.