Superselective arterial embolization for patients with high-flow priapism: results of follow-up for five or more years
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Published on: August 26, 2025
1Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. yasutaka@m3.kufm.kagoshima-u.ac.jp
Insights
Transcatheter arterial embolization effectively treats high-flow priapism, restoring normal erectile function and detumescence. This minimally invasive procedure offers long-term success in patients with traumatic or idiopathic cases.
Area of Science:
- Urology
- Interventional Radiology
Background:
- High-flow priapism, often linked to trauma, requires effective treatment to prevent long-term complications.
- Transcatheter arterial embolization offers a minimally invasive approach to managing vascular abnormalities causing priapism.
Purpose of the Study:
- To assess the long-term efficacy and outcomes of superselective transcatheter arterial embolization for high-flow priapism.
Main Methods:
- Retrospective analysis of six patients with high-flow priapism treated via superselective embolization of internal pudendal arteries.
- Follow-up duration of at least five years for all patients.
- Utilized embolization materials included gelatin sponge and microcoils.
Main Results:
- A total of nine embolization procedures were performed across six patients.
- All six patients achieved detumescence and normal erectile function at long-term follow-up (> or = 5 years).
- No procedural complications were reported, and successful outcomes were achieved even when complete pseudoaneurysm occlusion was not initially obtained.
Conclusions:
- Superselective embolization of the internal pudendal artery is a highly effective treatment for high-flow priapism.
- The procedure demonstrates excellent long-term results, including restoration of erectile function and resolution of priapism.
Purpose:
To retrospectively evaluate the long-term results of transcatheter arterial embolization for high-flow priapism.
Material And Methods:
The study comprised six patients with high-flow priapism treated by superselective embolization of the internal pudendal arteries at our institution. The cause of priapism was traumatic in five patients and idiopathic in one. Follow-up was > or = 5 years in all cases.
Results:
A total of nine embolizations were performed in the six patients. Embolization was performed once in three patients, while repeated embolizations were performed in the remaining three. Eleven arteries were altogether treated. Embolic materials used were gelatin sponge in nine arteries, gelatin sponge and microcoils in one, and microcoils alone in one. Embolization of the internal pudendal arteries on both sides in one single session was performed in one patient. In one patient, complete occlusion of the pseudoaneurysm was not achieved. However, restoration of erectile function and detumescence were noted during follow-up. Complications during the procedure were not registered. At follow-up > or = 5 years after successful embolization, all six patients experienced detumescence as well as normal erectile function.
Conclusion:
Superselective embolization of the internal pudendal artery is the procedure of choice for treatment of high-flow priapism.
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