The man got a tattoo from a tattoo artist who used a hand needle. While this method of tattooing is not uncommon, in this case the result was poor quality and led to an unexpected side effect. (Image credit: Neuroplastic Creative via Getty Images)
Patient: 21-year-old male from Iran.
Symptoms: The man reported that his penis remained “partially hard” for three months.
What happened next: Upon examination, doctors noticed that the patient had a tattoo on the top of his penis, as well as another on the head. The man initially claimed that he had gotten the tattoos several years ago, but later clarified that they were done just before the symptoms began.
The patient said the tattoo artist used a hand-held needle, a common traditional tattooing technique. He experienced bleeding and pain for several days. After the pain subsided, the man began experiencing “longer-than-usual erections that occurred during sleep,” which worsened to the point where his penis was constantly “semi-hard.”
Doctors further examined his medical history and ran a variety of lab tests, including an MRI to look for abnormalities and blood tests to rule out infection. Using ultrasound waves to assess blood flow in his penis, doctors found “pseudoaneurysms” in the area of the tattoo, indicating damaged arteries and blood buildup.
Diagnosis: The man was diagnosed with non-ischemic priapism. Priapism is a prolonged erection that occurs without sexual stimulation or continues long after it has stopped.
The most common type of priapism, ischemic priapism, occurs when a blockage prevents deoxygenated blood from leaving the penis or when certain medications impede this flow. This can quickly lead to tissue damage, permanent scarring, and impotence.
However, in non-ischemic priapism, blood flow is not blocked, so pain is less severe and the risk of permanent damage is lower. Also known as “high-flow priapism,” this condition typically occurs when an artery in the erectile tissue is damaged, allowing too much blood to continually flow into the penis.
Treatment: The treatment he needed wasn't available at the facility where he was seen, so he was referred to another facility for superselective embolization, a procedure that would block blood flow through the damaged arteries, reducing blood flow to the penis. Instead, he was given an “off-label” procedure that didn't make sense for his particular case. (The doctors didn't say in the case report where or why this alternative procedure was performed.)
The procedure involved placing shunts, or passageways for blood, between two tissues: the corpora cavernosa and the corpora spongiosum. In ischemic priapism, blood pools in the corpora cavernosa, so these shunts help the blood drain properly. But in nonischemic priapism, blood flow is not blocked, and the surgery would have no effect. “As expected, the procedure was unsuccessful,” the doctors wrote in their case report.
After the procedure, the man continued to experience semi-rigid priapism. He was disappointed with the results of the surgery. However, the condition was painless and he retained “moderately good” erectile function during intercourse. For these reasons, he decided to forgo further treatment and continues to live with the condition, his doctors said.
What makes this case unique: At the time of publication of the case in 2012, doctors noted that it was “the first case of non-ischemic priapism following a penile tattoo” ever described in the medical literature.
Priapism can have a variety of triggers. For example, ischemic — or “low-flow” — priapism can be associated with sickle cell anemia; blood cancers such as leukemia; and medication use, including some antipsychotics, antidepressants, and erectile dysfunction medications. High-flow priapism accounts for only about 5% of priapism cases and is most often caused by physical trauma to the penis or perineum.
Sourse: www.livescience.com
