Heparin and prednisone-associated priapism: two case reports

Priapism is a prolonged penile erection that is not associated with sexual stimulation. In this report, two patients who developed priapism 2-4 h after an oral prednisone and intravenous heparin infusion are described. Low-flow (ischaemic) priapism is usually associated with sickle cell disease, haemoglobinopathies, neoplastic syndrome, anticoagulant therapy (heparin and warfarin), psychotropic medication, sildenafil citrate (Viagra) or idiopathic causes. Here we report two cases of prolonged low-flow priapism induced by heparin and prednisone. Treatments were successfully conducted after the priapism, while the exact mechanism remains unclear.