High-flow priapism: treatment and long-term follow-up.
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.
Ciampalini
Sandro
S
Department ofUrology, University of Trieste School of Medicine, Trieste, Italy.
Savoca
Gianfranco
G
Buttazzi
Lorenzo
L
Gattuccio
Ignazio
I
Mucelli
Fabio Pozzi
FP
Bertolotto
Michele
M
De Stefani
Stefano
S
Belgrano
Emanuel
E
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