Priapizm, uyarý olmaksýzýn 4 saatten uzun süren penil ereksiyon olarak tanýmlanýr. Olgularýn çoðu, kýsmen veya tamamen kavernöz arter akýmýnýn olmadýðý iskemik priapizmdir. Priapizm nadir görülen bir durum olup yýllýk insidansý yaklaþýk 100.000 kiþide 1.5 vakadýr. Kronik miyeloid lösemi (KML) hastalarýnda lökostaza baðlý olarak %1–2 oranýnda priapizm geliþebilmektedir. Sunulan olguda; serebral palsi öyküsü bulunan 21 yaþýnda erkek hasta, 13 saattir devam eden priapizm nedeniyle ailesi tarafýndan acil servise getirildi. Travma öyküsü olmayan hastanýn, bir ay önce kendiliðinden düzelen tek bir priapizm ataðý öyküsü olduðu öðrenildi. Hastanýn fizik muayenesinde serebral palsiye baðlý ekstremite kontraktürleri tespit edildi ve penisin rijid olduðu gözlemlendi Korpus kavernozuma venöz kateter yerleþtirilerek koyu renkli kan aspire edildi ve kan gazý analizi sonucunda iskemik priapizm tanýsý doðrulandý. Korpus kavernozum fizyolojik serum ile irrige edildi ve her iki korpus kavernozuma epinefrin uygulandý; ancak priapizm gerilemedi. Laboratuvar testlerinde kan lökosit sayýsý 581.760 /mm³ olarak saptanmasý üzerine hasta Hematoloji bölümü tarafýndan deðerlendirildi. Yapýlan periferik yayma incelemesi sonucunda KML tanýsý kondu ve hastaya iki gün içerisinde üç defa lökoferez uygulandý. Kan lökosit sayýsýnýn normal sýnýrlara gerilemesinin ardýndan penil detümesans saðlandý ve tekrar priapizm ataðý görülmedi. Sonuç olarak, erken taný ve multidisipliner yaklaþým, priapizm tedavisinde baþarýyý artýrmakta ve komplikasyon riskini azaltmaktadýr.

Priapism as the Initial Presentation of Chronic Myeloid Leukemia in a Patient with Cerebral Palsy: A Case Report

Priapism is defined as a penile erection lasting more than four hours without stimulation. The majority of cases involve ischemic priapism, in which there is partial or complete absence of cavernosal arterial flow. Priapism is an uncommon condition, with an estimated annual incidence of approximately 1.5 cases per 100,000 men. In chronic myeloid leukemia (CML) patients, leukostasis may be observed, which can lead to priapism in 1-2% of cases. In our case; A 21-year-old patient with a history of cerebral palsy was brought to the emergency department by his family due to priapism persisting for 13 hours. It was learned that the patient had experienced a single previous episode of priapism one month earlier, which had resolved spontaneously. The patient had no history of trauma. On physical examination, extremity contractures related to cerebral palsy were noted and the penis was observed to be in an erect state. A venous catheter was inserted into the corpus cavernosum, dark-colored blood was aspirated, and blood gas analysis was confirmed the diagnosis of ischemic priapism. The corpus cavernosum was irrigated with normal saline and epinephrine was administered into both corpora cavernosa; however, priapism did not resolve. Laboratory tests revealed a white blood cell count of 581,760 /mm³. The patient was referred to the hematology department. Peripheral blood smear analysis led to the diagnosis of CML, and leukapheresis was performed three times within two days, following the normalization of the peripheral white blood cell count, penile detumescence was achieved and and no further episodes of priapism occurred. As a conclusion, early diagnosis and a multidisciplinary approach will improve priapism treatment success and reduce the risk of complications.