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High-flow priapism following perineal trauma in a child
Jessica Burns1, Simon Rajendran1, Alistair Calder2
1Department of Urology, Great Ormond Street Hospital, London, UK.
Insights
Traumatic high-flow priapism in children, often linked to injury, can be effectively treated with selective arterial embolization. Early diagnosis via Doppler ultrasound and prompt intervention are crucial for successful outcomes.
Area of Science:
- Pediatric Urology
- Interventional Radiology
Background:
- Priapism is a rare pediatric condition with high-flow and low-flow classifications.
- Traumatic high-flow priapism presents with prolonged, painless partial erection following antecedent trauma.
Abstract:
Priapism is a rare condition in children and can be classified as high or low flow. We present a case of traumatic high-flow priapism that was successfully managed by selective embolisation of a branch of the internal pudendal artery. The pertinent clinical features are antecedent trauma and prolonged painless partial erection. The investigation of choice is Doppler ultrasound. Management can either be conservative, radiological or surgical. While conservative management can be safely attempted for 6 weeks, given the nature of the condition, early intervention is often required. Radiological embolisation is the first line and is successful in 97% of cases. Surgery carries a higher morbidity and is only reserved in cases where repeated embolisation has failed. This case highlights the importance of a thorough history and careful interpretation of imaging with protocolised follow-up of patients by a paediatric urologist for early and accurate diagnosis of erectile dysfunction and prompt intervention to prevent future complications.
