True priapism is a pathologic erection of the penis characterized by persistence, pain, and absence of libido. It has been recognized as an occasional symptom and complication of leukemia since Jadioux1 reported the first case in 1845. Additional reports appeared sporadically, and by carefully reviewing the literature up to 1914, Hinman2 collected a total of 45 cases with a definite relation to leukemia.
Approximately 25 per cent of the total cases of priapism are associated with leukemia. This association occurs in both the acute and the chronic form of myelogenous and lymphogenous leukemia, but appears much more frequently in the myelogenous.3 The reported incidence of priapism in leukemia varies widely. Whereas Warthin4 stated that he obtained a history of priapism in about one-fourth of his cases, Cabot5 did not find a single instance of priapism in his series of 89 cases of leukemia. Craver6 reported 1 case in 100 men with leukemia.
ETIOLOGY AND PATHOLOGY
The etiology of priapism in leukemia is nervous and mechanical. Kunst,7 in support of nervous etiology, described a patient with hyperesthesia of the anal region, scrotum, and penis in whom priapism was relieved by supporting the spleen with an abdominal binder. He attributed priapism to compression of the sympathetics by the enlarged spleen. Ruh8 suggested that a thrombus forming in the cord and disturbing the third, the fourth, and the fifth sacral segment might cause priapism. Barney9 reported a case complicating leukemia in which priapism occurred after normal coitus. Postmortem studies by Warthin4 and. . .