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Successful superselective arterial embolization for post-traumatic high-flow priapism.

Tetsuya Takao¹, Keigo Osuga, Akira Tsujimura

¹Department of Urology, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka 565-0871, Japan. takao@uro.med.osaka-u.ac.jp

International Journal of Urology : Official Journal of the Japanese Urological Association

|April 14, 2007

Summary

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Superselective embolization successfully treated high-flow priapism in an 18-year-old male following perineal trauma. This interventional radiology technique restored erectile function and prevented recurrence, offering an alternative to prolonged conservative management.

Area of Science:

Interventional Radiology
Urology

Background:

High-flow priapism, often post-traumatic, requires effective management to preserve erectile function.
Conservative treatments are typically the first line for high-flow priapism.

Observation:

An 18-year-old male presented with sustained, painless erection 12 days after perineal injury.
Diagnosis of high-flow priapism was confirmed via cavernosal blood gas analysis and Doppler ultrasonography.

Findings:

Arteriography revealed an arterial-venous fistula in the cavernous artery.
Superselective embolization of the fistula using gelatin sponge particles achieved complete resolution.
The patient experienced full erectile function recovery and no priapism recurrence after one year.

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Implications:

Superselective arterial embolization is a viable treatment option for high-flow priapism.
This minimally invasive approach can be considered when conservative measures exceed three weeks without success.
Successful embolization preserves long-term erectile function and prevents priapism recurrence.