Erectile dysfunction and priapism

Background A 46-year-old man presented with erectile dysfunction following a blunt perineal injury sustained 1 year previously. Oral phosphodiesterase type 5 inhibitors failed to improve his erections. The remainder of the patient's history, physical examination and laboratory tests were unremarkable except for a moderate tenderness in the left perineum and some 'fullness' in the corpora cavernosa during physical examination. Investigation Physical examination, color duplex ultrasound of the penis and perineal area and Sexual Health Index for Men questionnaire. Diagnosis Non-ischemic priapism due to a ruptured left helicine artery, intermittent penile turgidity and erectile dysfunction. Management Open suture ligation of the helicine artery and imbrication of the pseudocapsule.