Italian Francesco Castriotta had been under house arrest while he awaited trial in Milan in 2009.
The 42 year old had begged the judge to not remand him to jail because his painful condition – priapism – would cause other inmates to mock him.
He is said to have sobbed in court while holding a bag of ice to his groin.
The judge took pity on the mobster and ordered him to be on house arrest until his trial, but he fled before he was due in court.
He was seized in El Vendrell in Spain yesterday, and will begin serving the 20-year sentence he was handed in his absence.
Castriotta said his condition was due to years of taking the class A drug cocaine.