title: High-flow priapism: treatment and long-term follow-up.
abstract: OBJECTIVE
  To determine the long-term follow-up of treatment of high-flow priapism, we reviewed the case records of 10 patients who were examined by the Urologic Clinic in Trieste from 1995 to 1998. High-flow or arterial priapism is a fairly rare dysfunction, generally resulting from penile or perineal trauma. In some cases, the etiology remains unknown.
  
  
  METHODS
  Trauma was reported in 6 of 10 cases. No etiologic causes were evident in the other patients. Nine patients underwent selective embolization during arteriography, and in 1 patient, corporotomy and ligature of the cavernous artery were performed. Color Doppler ultrasonography was repeated 1 day, 1 month, and 6 months after the operation. The determination of erectile function at a mean follow-up of 41 months (range 17 to 64) was performed using the International Index of Erectile Function.
  
  
  RESULTS
  Postoperatively, color Doppler ultrasonography revealed the absence of recurrence in 6 patients. Fistula recurrence was detected in 4 of 9 patients treated with selective embolization (44%). In three of these patients, a second embolization procedure was conclusive. In 1 case (11%), three consecutive embolizations were not conclusive and surgical ligature of the dorsal artery and collateral at the emergence of the penile root, out of the corpus cavernosum, was required. Sexual function was completely preserved in 80% of patients.
  
  
  CONCLUSIONS
  Pudendal angiography with superselective embolization is the treatment of choice. It is well tolerated and ensures a high preservation of premorbid erectile function.
authors.affiliation: Department ofUrology, University of Trieste School of Medicine, Trieste, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Ciampalini
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Savoca
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Buttazzi
authors.forename: Ignazio
authors.initials: I
authors.lastname: Gattuccio
authors.forename: Fabio Pozzi
authors.initials: FP
authors.lastname: Mucelli
authors.forename: Michele
authors.initials: M
authors.lastname: Bertolotto
authors.forename: Stefano
authors.initials: S
authors.lastname: De Stefani
authors.forename: Emanuel
authors.initials: E
authors.lastname: Belgrano
mesh_terms: D000293:Adolescent; D000328:Adult; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000293:injuries; D011317:Priapism / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D018615:Ultrasonography, Doppler, Color