title: Therapeutic embolization of high-flow priapism 1 year follow up with color Doppler sonography.
abstract: OBJECTIVE
  The aim of this study was to evaluate the use of color Doppler sonography (CDS) for the diagnosis of high-flow priapism and the treatment of cavernosal arterial fistula via super-selective arterial embolization.
  
  
  METHODS
  We reviewed eight cases of high-flow priapism with cavernosal arterial fistula, from 2005 to 2011. All of the patients were diagnosed with a high-flow priapism and unilateral artery fistula via CDS. Conventional treatments for the eight cases were unsuccessful, and the patients were then treated through super-selective embolization. Diagnostic angiograms of the internal iliac artery showed a fistula on one side of the cavernosal artery, thus confirming the CDS images. We compared hemodynamic parameters including the peak systolic velocity, end diastolic velocity the resistance index of the pathological cavernosal artery and intracavernosal pressure in all patients before and after treatment using t-test. The efficacy of super-selective embolization and the erectile function of all patients were evaluated at a follow-up time of 12 months.
  
  
  RESULTS
  All patients were successfully treated and angiography showed that the fistulas disappeared after treatment. Additionally significant differences were found in the peak systolic velocity, the end diastolic velocity, the resistance index and intracavernosal pressure between pre-treatment and post-treatment (P<0.05). At 5 days post-treatment, only one case relapses had occurred. Seven cases displayed restored erectile function and only one case exhibited erectile dysfunction.
  
  
  CONCLUSIONS
  Color Doppler sonography is a highly sensitive method for the examination of high-flow priapism, and super-selective embolization is a safe and effective treatment for cavernosal arterial fistula.
authors.affiliation: Department of Radiology, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuhan 430071, Hubei, PR China. Electronic address: zhaosong1984@QQ.com.
authors.forename: Song
authors.initials: S
authors.lastname: Zhao
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Zhang
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Zhang
authors.forename: Qing-Yun
authors.initials: QY
authors.lastname: Long
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011317:Priapism / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult
chemical_list: D006490:Hemostatics
keywords: Color Doppler sonography; Priapism; Super-selective arterial embolization