Introduction: High-flow priapism is an uncommon urological condition, most frequently associated with blunt perineal trauma. Non-traumatic presentations are rare and may pose a diagnostic challenge.
Case Presentation: We report the case of a 65-year-old man who developed painless persistent partial penile erection three days in duration after initiating combination therapy with tamsulosin and tadalafil for lower urinary tract symptoms. Cavernosal blood gas analysis and penile Doppler ultrasonography confirmed the diagnosis of high-flow priapism. Conservative management resulted in complete spontaneous resolution within two weeks.
Discussion: High-flow priapism accounts for approximately 5–10% of all cases of priapism. Although trauma remains its principal cause, isolated reports have suggested a possible association with phosphodiesterase type-5 inhibitors. Early recognition allows appropriate diagnosis and prevents unnecessary invasive interventions.
Conclusions: Clinical evaluation combined with cavernosal blood gas analysis and penile Doppler ultrasound provides accurate diagnosis. Conservative management remains an appropriate initial strategy in clinically stable patients.
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