Priapism can occur when pathologic stimuli (e.g. lesions of the cervical spinal cord) cause prolonged erection, and when normal stimuli under pathologic circumstances (e.g. sickle cell disease, leukemia) produce prolonged erection. As any priapism eventually leads to permanent impotentia coeundi, immediate therapy is absolutely indicated. All unspecific procedures are useless and merely waste time. The priapism in connection with hematologic diseases must be countered by conservative specific therapy (sickle cell disease by blood transfusions; leukemias by cytostatic drugs). All other forms of priapism must be treated by surgery as soon as possible. The operation of choice today perineal bilateral shunt between the corpus cavernosum and the corpus spongiosum