Bilateral superselective arterial microcoil embolization in post-traumatic high-flow priapism: a case report.
Priapism is a prolonged penile erection unrelated to sexual stimulation. High-flow arteriogenic priapism is uncommon and usually occurs after genitoperineal trauma, which may damage a feeding cavernosal artery, leading to an arteriovenous fistula and, occasionally, to an associated pseudoaneurysm. The defects rarely occur bilaterally. Herein, we report successful treatment of high-flow priapism secondary to a traumatic pseudoaneurysm fed from the bilateral cavernosal artery. Diagnosis was made after cavernosal blood gas analysis, color Doppler ultrasonography, and superselective angiography. Treatment consisted of superselective arterial embolization using metallic microcoils and resulted in simultaneous detumescence of the penis with no complications. The patient regained morning erection on the second postoperative day and erectile function remained normal 8 months after treatment. This case shows that bilateral arteriocavernosal fistulae can be successfully treated with superselective arterial embolization without affecting potency and highlights the importance of warning men about the possibility of developing high-flow priapism following a perineal trauma.
Department of Urology, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yung-Chin
YC
Lee
Jung-Tsung
JT
Shen
Ming-Chen
MC
Shih
Chung-Chin
CC
Chen
Yii-Her
YH
Chou
Chun-Hsiung
CH
Huang
D000328:Adult; D017541:Aneurysm, False / Q000150:complications*; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008297:Male; D010413:Penis / Q000098:blood supply*; D011317:Priapism / Q000628:therapy*