Ischemic Priapism Progressing to Penile Gangrene in a Patient with COVID-19 Infection: A Case Report with Literature Review

Table 1

Documented cases of priapism related to COVID-19 infection in the literature.

Study	Age (y)	Type of priapism	Duration of priapism	ICU admission	Drug history	Medical history/comorbidities	Treatment of priapism	Follow-up/outcome	Purported priapism risk factors
Lam et al., 2020 [6]	67	Ischemic	Unknown duration	N/A	Warfarin	Dilated cardiomyopathy of unknown etiology, left bundle branch block, cutaneous scleroderma, paroxysmal atrial fibrillation, DM type 2, and iron deficiency anemia	Conservative	Died due to clinical deterioration	Minor trauma
									Warfarin
Silverman et al., 2021 [7]	69	Ischemic	Unknown duration (>3 hours)	Yes	N/A	Obesity	Intracavernosal phenylephrine injection	Achieved detumescence, but eventually died due to clinical deterioration	Propofol
Lamamri et al., 2021 [8]	62	Ischemic	Unknown duration (>4 hours)	Yes	None	Left inguinal surgery and appendectomy	Intracavernosal ethylephrine injection	Achieved detumescence and was discharged to ward	None
Addar et al., 2021 [9]	62	Ischemic	10 days	Yes	N/A	HTN and dyslipidemia	Intracavernosal phenylephrine injection	Achieved detumescence and was discharged home	None
Carreño et al., 2021 [10]	39	Ischemic	3 days	Yes	None	Overweight	Intracavernosal adrenaline injection	Failed to achieve detumescence and eventually died due to clinical deterioration	Propofol
Grimberg et al., 2021 [11]	45	Stuttering ischemic priapism	Unknown duration (>4 hours)	N/A	N/A	HTN and benign prostatic hyperplasia	Intracavernosal phenylephrine injection	Achieved detumescence, but had recurrence 8 h later and was managed with another intracavernosal phenylephrine injection. He achieved detumescence eventually with no recurrence afterward. He was discharged home	None
Larrarte-arenas et al., 2021 [12]	65	Ischemic	30 hours	No	Nifedipine, prazosin, calcitriol, subcutaneous erythropoietin, and unfractionated heparin	Chronic kidney disease on hemodialysis, HTN, secondary hyperparathyroidism, and anemia	Intracavernosal epinephrine injection	Achieved detumescence	Renal replacement therapy
									Prazosin
Giuliano et al., 2021 [13]	34	Ischemic	36 hours	No	None	None	Initially, intracavernosal phenylephrine injection (failed to achieve detumescence). Then, a bilateral T-shunt procedure was performed.	The bilateral T-shunt helped to achieve detumescence, and the patient was discharged home. However, it was complicated by complete erectile dysfunction after 3 months of follow-up	None
Our case	66	Ischemic priapism progressed to penile gangrene	3 days	Yes	Amlodipine, insulin NovoMix, hydralazine, warfarin, risperidone, and mirtazapine	DM type 2, HTN, ischemic cardiomyopathy, chronic kidney disease, atrial fibrillation, cerebrovascular accident, and depression	Partial penectomy	The patient improved and eventually was discharged home	Warfarin
									Antidepressant/antipsychotic