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[High-flow priapism caused by bilateral arterio-lacunar fistula]
Alvaro de Pablo Cárdenas1, Javier Ignacio Jiménez Aristu, Francisco Lozano Uruñuela
1Servicio de Urología, Hospital Virgen del Camino, Pamplona, España.
Objective:
Literature review about arterial priapism cases secondary to bilateral postraumatic arterial-lacunar fistula, with special attention to therapeutic management by bilateral supraselective embolization.
Methods:
Bibliographic search using MEDLINE. A new case of high flow priapism secondary to bilateral postraumatic arterial-lacunar fistula is reported.
Results:
There are a total of ten cases of arterial priapism secondary to bilateral postraumatic arterial-lacunar fistula. Only one patient was treated by embolization in two steps with reabsorbable material; non reabsorbable material was used for embolization in three patients; in four cases embolization was performed as a single procedure and the remainder two cases resolved spontaneously. Erectile function was recovered independently of the therapeutic option performed.
Conclusions:
Embolization in two steps with reabsorbable material has been postulated as the treatment for arterial priapism secondary to bilateral postraumatic arterial-lacunar fistula or in cases of high flow status and drepanocytosis which do not resolve with other therapeutic measures. Nevertheless, if supraselective embolization is performed, it could not be mandatory to follow this therapeutic criteria, as it is suggested by erectile function results obtained.