Priapism: A Rare Complication Following Epidural and Extended Lithotomy

Case report

A 59-year-old healthy Caucasian male had a perineal prostatectomy for Gleason 3+3 adenocarcinoma of the prostate. He had a mild degree of hypospadias, no meatal stenosis, and a 30 cc gland on magnetic resonance imaging (MRI).

Abstract

Epidural analgesia is increasingly being used in patients undergoing major surgical procedures for effective pain relief in the immediate postoperative period. The injection can cause both anesthesia and analgesia, by blocking the transmission of signals through nerves in or near the spinal cord. Epidural analgesia, however, is associated with complications, and although priapism is not a very common complication, it is not unheard of. We describe a case of priapism in a patient who was given epidural analgesia via a lumbar epidural catheter followed by extended lithotomy position, which resolved with merely altering the patient's posture.

Keywords

Epidural, extended lithotomy, priapism