CASE REPORT 22 Introduction Preservation of normal erectile function is the major goal in the management of priapism. Ischemic priapism is a urological emergency due to compartment syndrome after 4 hours of prolonged erection. However, ischemic priapism has not yet been reported in a neonate. Priapism in newborn is challenging situation for pediatric urologists because of the lack of experience due to paucity of cases, and well- established guidelines. Therefore, evaluation and management strategy remains unclear. Here, we present the latest two cases of newborn priapism and review of the literature. Case Presentation First case was the second child of a 31-year-old woman. The newborn was delivered by cesarean section at the 39 th week of gestation with a birth weight of 2870 g. Appearance, Pulse, Grimace, Activity, Respiration (APGAR) test scores were 9/10 and 9/10 at 1 and 5 minutes, respectively. There was no evidence of blood group incompatibility and hematological pathology in the newborn. Blood count, biochemical analysis, and physical examination revealed no abnormality and, neurological examination was normal. Maternal hypothyroidism, for which she used levothyroxine, and a history of smoking during pregnancy was noted. Routine prenatal examinations were performed regularly. The patient was referred to the pediatric urology department at the second day of life with prolonged erection which was noticed at the frst day of life by the parents. Physical examination showed rigid penis without cyanosis and tenderness (Figure 1). The testes were descended bilaterally and normal on physical examination. Projectile voiding was observed without restlessness and, defecation was normal. Penile Doppler ultrasound scan revealed normal arterial and venous fow and there was no evidence of ischemic priapism. Polycythemia and other hematological disorders were ruled out after pediatric hematology consultation. The patient underwent conservative follow-up. Spontaneous detumescence was achieved at the 6 th day of life without any surgical intervention. His course was uneventful. No recurrence and abnormality was observed during 6 months of follow-up. ABSTRACT ÖZ Yenidoğan priapizmi nadir görülen bir hastalık olup 1879’dan şimdiye kadar literatürde 15 olgu bildirimi yapılmıştır. En sık rastlanan etiyolojik faktör polisitemi olsa da, çoğunlukla idiyopatiktir. Yenidoğan priapizmi genellikle iskemik olmayan tipte seyreder. Tedavide çoğu zaman cerrahi müdaheleye gerek kalmaz. Konservatif yaklaşım en iyi seçenek olarak görünmektedir. Bu olgu sunumunda konservatif izlem ile yaşamın 6. ve 7. günlerinde gerileyen iki yenidoğan priapizm olgusunu sunulmaktadır. Olgu sunumu ile beraber en uygun yaklaşım ve değerlendirme için yol göstermesi amacıyla literatür derlemesi de sunulmuştur. Anahtar Kelimeler İdyopatik, konservatif, priapizm, yenidoğan, yaklaşım Priapism in a newborn is a rare entity with only 15 cases reported in the literature since 1879. The most commonly detected etiologic factor is polycythemia, but most of the cases are idiopathic. Conservative treatment seems to be suffcient and surgical approach is usually unnecessary. Here, we present a prolonged erection in two newborns which occurred at the frst day of life and detumescence was achieved with conservative approach at the 6 th and 7 th day of life, respectively. We also reviewed the literature to investigate the most adequate evaluation and management criteria. Keywords Idiopathic, conservative, priapism, neonatal, management Correspondence Cem Akbal MD, Marmara University Faculty of Medicine, Department of Urology, İstanbul, Turkey E-mail: cakbal@gmail.com Received: 26.05.2015 Accepted: 08.06.2015 Marmara University Faculty of Medicine, Department of Urology, İstanbul, Turkey Farhad Talibzade, Cem Akbal, Çağrı Akın Şekerci, Mehmet Özay Özgür, Haydar Kamil Çam, Ferruh Şimşek Yenidoğan Priapizmine Yaklaşım: İki Olgu Bildirimi ve Literatür Derlemesi Management of Neonatal Priapism: Report of Two Cases and Review of the Literature CASE REPORT PEDIATRIC UROlOgy Doi: 10.4274/jus.403 Journal of Urological Surgery, 2016; 1: 22-24