title: Treatment of high-flow priapism with superselective transcatheter embolization in 27 patients: a multicenter study.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of treatment of high-flow priapism (HFP) with superselective transcatheter embolization at nine university hospitals.
  
  
  METHODS
  Between May 1994 and October 2006, 27 patients underwent superselective embolization of the cavernous artery for HFP. Trauma was apparent in 22 patients, there was self-administered intracavernosal injection for erectile dysfunction in two, and the remaining three did not recall any penile or perineal trauma. The embolic agents used were autologous blood clot (n = 12), gelatin sponge (n = 12), microcoils combined with gelatin sponge (n = 1), polyvinyl alcohol (n = 1), and N-butyl cyanoacrylate (n = 1). Recurrence of priapism and change in erectile function were evaluated during a mean follow-up of 13 months. Differences in results between patients treated with autologous blood clot versus gelatin sponge were statistically analyzed with use of the chi(2) test.
  
  
  RESULTS
  In 24 of 27 patients (89%), a single embolization was sufficient for complete resolution of priapism. Repeat embolization was required in two patients (7%), and in the remaining patient (4%), shunt surgery was performed after embolization as a result of HFP coexisting with corporeal venoocclusive dysfunction. Eighteen of 23 patients (78%) who had premorbid normal erectile function showed maintained potency during the follow-up period. There was no significant difference affecting required repeat embolization (P = .537) and change in quality of erection (P = .615) during the follow-up period between the autologous blood clot and gelatin sponge treatment groups.
  
  
  CONCLUSIONS
  Superselective transcatheter embolization in the treatment of HFP is effective and ensures a high level of preservation of premorbid erectile function.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Kyung Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Yoon
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Ahn
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Kim
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Heung-Kyu
authors.initials: HK
authors.lastname: Ko
authors.forename: Byung Kook
authors.initials: BK
authors.lastname: Kwak
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Shim
authors.forename: Hwan-Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.forename: Jae-Ik
authors.initials: JI
authors.lastname: Bae
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D010410:Penile Erection; D010413:Penis / Q000098:blood supply*; D011317:Priapism / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011859:Radiography; D012008:Recurrence; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy