• Tattooing;
  • Priapism;
  • Injections


Introduction.  To our knowledge, here we report the first case of nonischemic priapism following penile tattooing.

Aim.  To report the first case of nonischemic priapism following penile tattooing.

Methods.  A case with tattooing-induced priapism is presented including subjective reporting, physical examination, and laboratory/radiologic evaluations.

Results.  A 21-year-old man, presented with partially rigid penis of 3-month duration. On examination, the penis was half rigid, with a tattoo on its dorsal surface, and a smaller tattoo on the glans (Figure 1). The patient initially stated that the tattoo had been created years ago, but later admitted that he had it created just before the occurrence of priapism. A traditional tattooist created the tattoo manually, using a handheld needle. Bleeding from deep penile tissue for several days complicated the tattooing.


Figure 1. Penile tattooing. The tattoo on dorsal penis reads in Persian “borow be salaamat” (“good luck with your journeys”). Also note the tattooed English letter “M” on the glans (“M” was the first letter of the first name of the patient's girlfriend).

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Known etiologies of priapism were investigated and ruled out. Specifically, perineal injury, leukemia, sickle cell trait, thalassemia, urinary tract infection, neurogenic, neoplastic, infectious, toxic, and pharmacological causes were actively investigated and ruled out. There was no history of alcohol consumption or smoking. Aspirated penile blood was bright red. Cavernous blood gas measurements confirmed high oxygen and low carbon dioxide content, diagnostic of arterial priapism.

There was no embolization facility in Kermanshah. In fact, there are few experts in superselective embolization in Iran. We referred the patient for superselective embolization. However, he underwent a nonindicated Sacher procedure. Predictably, the procedure was unsuccessful. At present, the patient continues to have priapism. Because of the painless nature of erections, moderately good preservation of erectile function during intercourses, and disappointment with former surgery, the patient declined further therapies, and he lives with his condition.

Conclusions.  Tattooing should be added to the etiologies of nonischemic priapism. Considering this case, we discourage penile tattooing. Zargooshi J, Rahmanian E, Motaee H, and Kohzadi M. Nonischemic priapism following penile tattooing. J Sex Med 2012;9:844–848.