High-flow priapism: superselective cavernous artery embolization with microcoils.
OBJECTIVE
To determine the effectiveness of superselective cavernous artery embolization.


METHODS
Eight patients with high-flow priapism were included in this study. All were treated by superselective cavernous artery embolization with microcoils and gelatin sponges. The follow-up examinations consisted of color duplex ultrasonography. The International Index of Erectile Function 5-item questionnaire was used to investigate the patients' erectile function before the onset of priapism, at embolization, and 6 months after embolization.


RESULTS
A unilateral cavernous fistula was found in 7 patients and bilateral fistulas in 1. Of the 8 patients, 2 (1 with unilateral and 1 with bilateral fistulas) initially underwent embolization with a gelatin sponge but presented with recurrence of tumescence 1 week after treatment and required a repeat embolization procedure with microcoils. The other 6 patients (75%) were successfully detumescent after embolization with microcoils. The 6 patients (75%) who underwent embolization with microcoils alone had normal erectile function with a mean International Index of Erectile Function score of 22.20 at 6 months after embolization. The 2 patients (25%) who had required repeat embolization had erectile dysfunction, with a mean International Index of Erectile Function score of 13.00.


CONCLUSIONS
Superselective cavernous artery embolization with microcoils is a safe and effective treatment of high-flow priapism. The use of microcoils resulted in greater embolization success and preservation of erectile function, especially in the treatment of a unilateral arterial fistula in a young patient.
Liu
Bao-xing
BX
Andrology Center and Department of Interventional Radiology and Vascular Surgery, First Hospital, Peking University, Beijing, China.
Xin
Zhong-cheng
ZC
Zou
Ying-hua
YH
Tian
Long
L
Wu
Yi-guang
YG
Wu
Xiao-jun
XJ
Song
Wei-dong
WD
Zhang
Zhi-chao
ZC
Gao
Bing
B
D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D010410:Penile Erection; D010413:Penis / Q000000981:diagnostic imaging; D011317:Priapism / Q000000981:diagnostic imaging* / Q000628:therapy*; D011859:Radiography; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D014572:Urology / Q000379:methods*