Successful superselective arterial embolization for post-traumatic high-flow priapism
Article first published online: 10 APR 2007
International Journal of Urology
Volume 14, Issue 3, pages 254–256, March 2007
How to Cite
Takao, T., Osuga, K., Tsujimura, A., Matsumiya, K., Nonomura, N. and Okuyama, A. (2007), Successful superselective arterial embolization for post-traumatic high-flow priapism. International Journal of Urology, 14: 254–256. doi: 10.1111/j.1442-2042.2007.01574.x
- Issue published online: 10 APR 2007
- Article first published online: 10 APR 2007
- Received 17 January 2006; accepted 27 April 2006.
- arterial embolization;
- high-flow priapism;
- perineal injury
Abstract: We report a case of high-flow priapism treated successfully with superselective embolization of the cavernous artery. An 18-year-old man presented to our hospital 12 days after having been struck in the perineum by the corner of a skateboard. Immediately after the injury, he suffered painless sustained incomplete erection. High-flow priapism was diagnosed on the basis of cavernosal blood gas analysis and color Doppler ultrasonography findings. Right internal pudendal arteriography showed blood pooling in the cavernosum as a result of a broken artery. We identified the precise position of the arterial–venous fistula and embolized it superselectively with gelatin sponge particles. The fistula disappeared completely. One year later, the patient’s erectile function was completely restored, and there had been no recurrence of the priapism. According to the American Urological Association guidelines, conservative treatment should be attempted first for high-flow priapism. In our review of the literature, superselective arterial embolization could be an alternative treatment after more than 3 weeks of conservative treatment.