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Ischaemic priapism and lack of efficacy: 3 case reports In a case series, three men aged 40-48 years were described; two men developed ischaemic priapism following treatment with trazodone. The third men exhibited lack of efficacy following treatment with phenylephrine and sodium chloride for ischaemic priapism [not all indications stated; routes, dosages and time to reaction onsets not stated]. Case 1: A 48-year-old man developed ischaemic priapism following treatment wit trazodone. The man, who was receiving trazodone, developed a 2-day episode of priapism. He was hospitalised. Following diagnostic workup, he underwent intracorporal blood aspiration and sodium chloride irrigation. His priapism episode was only briefly controlled. A second attempt was made at operative management consisting of a corporal incision at the proximal penile shaft on the right side to evacuate blood. However, his priapism did not resolve. Subsequently, a penile ultrasound confirmed bilaterally absent blood flow in the cavernosal arteries. Approximately 5 days after priapism onset, he presented to another hospital with worsening penile pain sensations and persistent rigid, tender corpora cavernosa. Thereafter, he was treated with modified Al-Ghorab distal penile corporoglanular shunt surgery leading to resolution of priapism. At re-evaluation five months later, he had not regained normal erections. Subsequently, he was lost to clinical follow-up. Case 2: A 43-year-old man developed ischaemic priapism following treatment with trazodone. The man, who was receiving trazodone, developed a 24-hour episode of priapism. He was hospitalised. Anamnesis revealed that four years earlier, he had experienced a brief priapism episode, following oral trazodone use. Erections had been preserved after that episode. His medical history was significant for type 2 diabetes mellitus and hypertension. His medications included insulin, unspecified oral hypoglycemic agent and oral angiotensin converting-enzyme inhibitor. Cavernosal blood gas testing confirmed ischaemic priapism. He was treated with intracorporal blood aspiration, sodium chloride and phenylephrine leading to only temporary resolution of his priapism. He also underwent Al-Ghorab corporoglanular shunt procedure without success. Approximately 48 hours after priapism onset, he was transferred to another hospital. He underwent modified Al-Ghorab distal penile corporoglanular shunt surgery leading to resolution of priapism. At re-evaluation one month later, he reported recovery of erections satisfactory for sexual intercourse. Subsequently, he was lost to clinical follow-up. Case 3: 40-year-old man exhibited lack of efficacy following treatment with phenylephrine and sodium chloride for ischaemic priapism. The man presented with a 3-day history of recurrent priapism with episodes lasting several hours at a time. He was hospitalised. His priapism had developed spontaneously. His medical history was significant for vasectomy. Following routine priapism evaluation, he was treated with phenylephrine