Lumbar spinal stenosis causing intermittent priapism.

The current report concerns the unusual symptom of intermittent priapism, or what may be termed 'involuntary penile erection', associated with proven degenerative lumbar spinal stenosis. Seven patients who were treated for intermittent claudication and spontaneous priapism during walking were studied in terms of clinical presentation, imaging findings, and some electrophysiological testing. Varying degrees of walking and standing tolerance with these unusual symptoms appeared to be correlated with cauda equina constriction as was seen by radiological imaging. Although not statistically valid, external urethral sphincter evoked electromyography suggested the possibility of monitoring the unusual symptom during walking. Surgical spinal decompression is recommended to alleviate this symptom and the claudication.