High-flow priapism is a rare, non-ischemic penile erection due to unregulated arterial inflow, usually from trauma. We report a 48-year-old male who developed high-flow priapism one day after vesicolithotripsy, with no trauma history. Despite pseudoephedrine, symptoms persisted. Examination showed a rigid, non-ischemic erection; a proximal shunt was performed after conservative measures failed. This case highlights a rare iatrogenic cause, possibly due to arterial injury from instrumentation or Foley removal. In settings without embolization access, surgical shunting remains a valid treatment. Early recognition is key to prevent complications and preserve erectile function.
Majid et al. (2026) studied this question.