title: Embolization for massive urethral hemorrhage.
abstract: Priapism is the term given to a prolonged, painful penile erection, unaccompanied by sexual desire. Most cases of priapism occur as a result of engorgement of the cavernous body of the penis due to intrinsic or extrinsic venous outflow obstruction, which is termed veno-occlusive priapism. However, in a small number of patients, the cause is related to uncontrolled arterial inflow due to trauma and resultant laceration of cavernosal arteries. This form of disease has been termed high-flow priapism and usually occurs in association with genitoperineal trauma. Most incidents of high-flow arteriogenic priapism result from genitoperineal trauma, such as that caused by sliding on a wooden bar or falling astride a ladder. We experienced a patient with a high-flow priapism due to urethral trauma caused by a misplaced Foley catheter. The treatment consisted of superselective arterial embolization of the bilateral internal pudendal arteries using metallic microcoils, which resulted in the subsequent detumescence of the penis with no complications. This case showed that bilateral arteriocavernosal fistulae can be successfully treated by superselective arterial embolization.
authors.affiliation: Department of Radiology, Gifu University School of Medicine, Gifu City, Japan. hkondo@cc.gifu-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kondo
authors.forename: Tohru
authors.initials: T
authors.lastname: Yamada
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanematsu
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kako
authors.forename: Satoshi
authors.initials: S
authors.lastname: Goshima
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D004621:Embolization, Therapeutic; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010413:Penis / Q000098:blood supply; D011317:Priapism / Q000209:etiology*; D015641:Radiography, Interventional; D012421:Rupture; D014521:Urethra / Q000293:injuries*; D014546:Urinary Catheterization / Q000009:adverse effects*