Materials in embolotherapy of high-flow priapism: results and long-term follow-up

To review our experience with embolic materials used in the selective arterial embolization of high-flow priapism and present the results of long-term follow-up.

Eight patients with traumatic high-flow priapism were reviewed. The patients were evaluated with clinical findings, laboratory examinations, and imaging findings including color Doppler ultrasonography and angiography. Diagnostic angiography demonstrated a connection between the cavernosal artery and the corpus cavernosum. Fistulas were embolized using autologous blood clot, polyvinyl alcohol particles, detachable coils, or acrylic glue. One or more procedures per patient were needed to achieve success.

Eleven embolization procedures were performed in eight patients. Immediate resolution of priapism was obtained after the procedures. Three patients (37.5%) had recurrence of priapism in the subsequent 1-3 weeks and required a repeat procedure. After the final procedures, all patients had complete resolution of priapism. Normal recurrence of erectile function was obtained in six of the patients (75%) after the final embolization.

Selective arterial embolization is a useful therapeutic option in the management of patients with high-flow priapism. Various materials can be used successfully as embolizing agents in the procedures according to the patient's status.