Numerous medications have been associated to the development of
priapism as an adverse reaction, the most common are intracavernosal vasoactive agents,
antipsychotics and
antidepressants. Alpha blockers, in particular
tamsulosin which is widely used in different urological conditions, has been associated to
priapism in only few case reports. We present the case of a healthy 45-year-old man who medicated himself with two doses of 0.4 mg of
tamsulosin due to a
renal colic with spontaneous passage of a 3 mm stone. Eight hours after the second
tamsulosin dose the patient developed a persistent painful erection not associated to sexual stimulation that lasted for 6 hours. He was admitted to the emergency room, and after history taking and physical evaluation the diagnosis of ischemic
priapism was made. The patient denied consumption of any other medication or
drug during the last month, blood tests in particular hemogram were normal and no recent history of pelvic
trauma was reported. To achieve detumescence, five boluses of 200 mcg of
phenylephrine were injected directly in the corpora cavernosa, no further procedures were needed. In the follow-up the patient had no new
priapism episodes and he reported no problems with erections in sexual intercourse.
Tamsulosin is one of most indicated medications in urological general practice; though
priapism has been rarely associated to its consumption the risk of this side effect exists, suggesting that patients should be counselled about it.