Treatment of high-flow priapism with superselective transcatheter embolization in 27 patients: a multicenter study.
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.
Kim
Kyung Rae
KR
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Shin
Ji Hoon
JH
Song
Ho-Young
HY
Ko
Gi-Young
GY
Yoon
Hyun-Ki
HK
Sung
Kyu-Bo
KB
Ahn
Tae-Young
TY
Kim
Chang Won
CW
Kim
Young Hwan
YH
Ko
Heung-Kyu
HK
Kwak
Byung Kook
BK
Shim
Hyung Jin
HJ
Chung
Hwan-Hoon
HH
Shin
Sung Wook
SW
Bae
Jae-Ik
JI
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