Daily phosphodiesterase type 5 inhibitor therapy as rescue for recurrent ischemic priapism after failed androgen ablation.

The objective of this report is to discuss the potential for normal hormone regulation and application of chronic phosphodiesterase type 5 inhibition for the management of recurrent ischemic priapism. A 64-year-old man presented with refractory priapism treated with antiandrogen therapy. He was transitioned to and well controlled on a regimen of daily phosphodiesterase type 5 inhibitor and every other week antiandrogen therapy. Our treatment of recurrent priapism implicates androgens and both biochemical and neurovascular control mechanisms in the penis.