A 32-year-old male, single, university student and professional athlete, with no other relevant backgrounds, diagnosed with paranoid schizophrenia for three years for which he has received regular treatment with 3 mg of risperidone daily.
She began to experience priapism spontaneously from dawn to night before entering the Emergency Room, intense, persistent and painful penile erection.
On physical examination, he was complaining, with stable vital signs and no other abnormalities except his notorious erection that respected the glans and spongy body.
Auxiliary tests include hematocrit of 38% and leukocyte count of 10,300 cells/mm3 (without left shift), peripheral blood smear was normal as well as coagulation tests, blood biochemistry and urogram.
Aspirated blood from vesicular bodies 89 showed an unequivocal dark dye and its gasimetry values were pH 6.7, pO2: 15.2 mmHg and pCO2:
Number of other etiological factors, the case was diagnosed as low flow priapism and the patient was provided with support measures (analgesia, sedation and hydration) in addition to performing an intradermal injection of 0.3 mL saline solution.
However, given the failure of the established medical treatment, at 22 h of evolution -the delay was due to lack of availability of operating theatre - it was decided to perform a surgical cavernous spongy derivation distal (surgical technique).
Subsequently, after 36 hours of observation, and due to the lack of adequate penile detumescence, the decision was made to submit the patient to a second intervention, this time with the technique of proximal Quackels (derivative).
During the follow-up period, spontaneous presence of erection at night was recorded one month after discharge and at six months, our patient achieved partial erection and could even perform intercourse.
He had also returned to receive 2 mg of risperidone, and remained stable in terms of his psychiatric condition.
Currently, four years after the described episode of priapism, the patient does not present erectile dysfunction and his psychotic condition is controlled with 450 mg of quetiapine daily.
