Introduction: Glans necrosis in association with priapism is very rare and its appropriate treatment is not known. There is a secondary cause in most cases.
Case description: We treated a 65-year-old man with priapism and glans necrosis using a closed shunt (Winter), continuous penile irrigation with normal saline, and heparin for 48 h and waited for the necrotic area to resolve spontaneously. The treatment outcome was much better compared to previous cases in whom open surgery, irrigation with pure normal saline, and/or resection of the necrotic area were performed.
Conclusion: In cases with priapism and glans ischemia, we recommend treating the condition with continuous covernose irrigation with heparinized saline and avoiding open surgery.
Keywords: Priapism; cavernous irrigation; glans necrosis; heparin; warfarin.