Treatment of "high-flow" priapism with superselective transcatheter embolization: a useful alternative to surgery

To review the efficacy of treatment of high-flow priapism with superselective transcatheter embolization.

Over a 2-year period, we reviewed five patients who were treated for traumatic high-flow priapism with superselective embolization. All patients underwent diagnostic angiography that demonstrated a communication between the cavernosal artery and the corpora cavernosa. Each identified fistula was embolized using gel-foam, blood clot, microcoils, or a combination of these.

All five patients had successful detumesence of priapism postprocedure. There was normal recurrence of early morning erection with successful detumescence for each patient within a 2- to 4-week period. Two of five patients (40%) presented with recurrence of priapism at 6 months and required a repeat embolization procedure. At 1 year, four of the five patients (80%) had normal erectile function.

Superselective transcatheter embolization is a useful therapeutic modality in the treatment of high-flow priapism. It provides equivalent rates of detumesence when compared to surgical techniques, and appears to have a greater success in preserving erectile function.