Refractory priapism associated with ingestion of yohimbe extract


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.


  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.

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Morales A. Yohimbe in erectile dysfunction: the facts.Int J Impot Res. 2000;12(suppl 1):S70-S74.

    Article  Google Scholar 

  3. 3.

    McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence.Altern Med Rev. 2004;9:4–16.

    PubMed  Google 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.

    Article  CAS  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Tam SW, Worcel m, Michael W. Yohimbine: a clinical review.Pharmacol Ther. 2001;91:215–243.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Fermin Barrueto MD.

Additional information

Notes: There was no outside funding of any kind used for this study

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Myers, A., Barrueto, F. Refractory priapism associated with ingestion of yohimbe extract. J. Med. Toxicol. 5, 223 (2009).

Download citation


  • yohimbe
  • priapism
  • erectile dysfunction