Neonatal priapism revealing polycythemia: A rare association—Case report

BackgroundNeonatal priapism is a rare and typically benign condition characterized by a persistent penile erection unrelated to stimulation. Unlike priapism beyond the neonatal period, which is more frequently ischemic, most neonatal cases are non-ischemic and idiopathic, although associations with polycythemia have been reported.Case presentationWe report the case of a male neonate born at 37 + 3 weeks of gestation who developed painless priapism on the first day of life, persisting for approximately 48 h. Clinical examination showed no penile discoloration or distress. Color Doppler ultrasound demonstrated preserved arterial and venous flow consistent with high-flow, non-ischemic priapism. A simple therapeutic phlebotomy was performed, resulting in complete detumescence within 24 h and normalization of hematologic parameters. The infant remained clinically stable, and 3-month follow-up showed no recurrence or complications.ConclusionThis case highlights the importance of considering polycythemia in the etiological assessment of neonatal priapism and supports a conservative approach when vascular flow is preserved. Early recognition and appropriate management can lead to favorable outcomes without long-term sequelae.