<![CDATA[Priapism is a urological emergency characterized by a penile erection lasting more than four hours without sexual stimulation, which may result in serious complications such as permanent erectile dysfunction if not promptly managed. While it is commonly associated with medication use, trauma, or hematological disorders, its occurrence as an initial manifestation of Chronic Myeloid Leukemia (CML) is exceedingly rare. We report the case of a 33-year-old man who presented to the Emergency Department of RSUD Wonogiri with a persistent painful erection lasting more than 48 hours, without any history of stimulant drug use, trauma, or prior sexual activity. Physical examination revealed a fully rigid and tender penis, pallor, tachycardia, and hepatosplenomegaly. Laboratory evaluation showed marked leukocytosis (320,000/µL), anemia (Hb 7.5 g/dL), and thrombocytopenia. Cavernosal aspiration yielded dark, hypoxic blood, and peripheral smear demonstrated a predominance of granulocytes with immature forms, consistent with chronic-phase CML. The patient underwent cavernosal aspiration and irrigation, and was subsequently referred to the hematology department for further management. This case emphasizes the need to consider priapism as a potential early sign of systemic diseases such as CML, and highlights the importance of rapid multidisciplinary intervention to prevent long-term complications.]]>
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