Immediate insertion of a semirigid penile prosthesis for refractory ischemic priapism.

The insertion of a penile prosthesis for reduction of ischemic priapism has previously been described for cases of sickle cell disease, delayed presentation, or failure of previous shunt surgery. We report the first case of immediate insertion of a malleable prosthesis as primary surgical therapy for refractory ischemic priapism in a patient with known preexisting erectile dysfunction. We propose a novel management algorithm incorporating the acute insertion of a penile prosthesis as an effective option in the management of refractory ischemic priapism.