Refractory priapism associated with ingestion of yohimbe extract

  • Amy Myers
  • Fermin BarruetoEmail author
Toxicology Observations


Extracts of the bark of the central African treePausinystalia yohimbe contain yohimbine, an indole alkaloid, which is used to treat erectile dysfunction. The reported side effects of over-the-counter preparations of yohimbine include gastrointestinal upset, anxiety, increased blood pressure, headache, agitation, rash, tachycardia, and frequent urination. In this report, we describe a severe case of intractable priapism associated with the ingestion of yohimbe extract. Management required insertion of a proximal cavernosal spongiosum shunt (Quackles shunt) in the operating room.


yohimbe priapism erectile dysfunction 


  1. 1.
    Guay AT, Spark RF, Jacobson, J, et al. Yohimbe treatment of organic erectile dysfunction in a dose-escalation trial.Int J Impot Res. 2002;14:25–31.CrossRefPubMedGoogle Scholar
  2. 2.
    Morales A. Yohimbe in erectile dysfunction: the facts.Int J Impot Res. 2000;12(suppl 1):S70-S74.CrossRefGoogle Scholar
  3. 3.
    McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence.Altern Med Rev. 2004;9:4–16.PubMedGoogle Scholar
  4. 4.
    Ernst E, Pittler MH. Yohimbe for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials.J Urol. 1998;159:433–436.CrossRefPubMedGoogle Scholar
  5. 5.
    Hatzichristou DG, Pescatori ES. Current treatments and emerging therapeutic approaches in male erectile dysfunction.BJU Int. 2001;88(suppl 3):11–17.CrossRefPubMedGoogle Scholar
  6. 6.
    Adeniyi AA, Brindley GS, Pryor JP, et al. Yohimbe in the treatment of orgasmic dysfunction.Asian J Androl. 2007; 9:403–407.CrossRefPubMedGoogle Scholar
  7. 7.
    Tam SW, Worcel m, Michael W. Yohimbine: a clinical review.Pharmacol Ther. 2001;91:215–243.CrossRefPubMedGoogle Scholar

Copyright information

© American College of Medical Toxicology 2009

Authors and Affiliations

  1. 1.Department of Emergency MedicineUniversity of Maryland School of MarylandBaltimore
  2. 2.Emergency DepartmentUpper Chesapeake Health SystemBel Air

Personalised recommendations