Leech Therapy for Treating Priapism: Case Report
Asgari SA, Rostami S, Teimoori M (2017) · Iranian Journal of Public Health · n=1
RCT evidence detailTrial reference
Study Profile
- Design
- single-patient case report (26-year-old single male, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran)
- Sample size (n)
- 1
- Intervention
- Bilateral leech therapy with two leeches on each side of penile shaft for 2 hours, followed by one-hour break, then another cycle in same manner
- Comparator
- No control - case report
- Primary endpoint
- Pain control and resolution of priapism (persistent painful penile erection without sexual stimulation)
- Primary result
- Significant pain reduction at 2-day follow-up despite persistent cavernosal swelling and tenderness; patient discharged after 3-day admission with complete resolution of pain and perineal swelling over 1 month
- Follow-up duration
- 1 month with complete symptom resolution
- PMID
- 28845411
Key Findings
- Priapism resolution with bilateral leech therapy protocol
- Two leeches per side, 2-hour cycles with 1-hour breaks
- Significant 2-day pain reduction
- Complete resolution over 1 month
- Non-invasive alternative to surgical intervention
Limitations
- Single case - hypothesis-generating only
- No mental disorders, trauma, or sickle cell anemia present
- Cannot quantify leech vs natural history contribution
- Limited generalizability to common priapism etiologies
- Off-label use beyond traditional K040187 indications
Clinical Implications
Asgari 2017 introduces hirudotherapy as a non-invasive alternative for refractory priapism management. For US clinicians under K040187, this Iranian case demonstrates extension of device indication to venous-congestion-mediated compartment syndromes outside traditional flap/replant contexts. However, the single-case design and absence of standard etiologies (trauma, sickle cell) limits clinical adoption.