High-flow post-traumatic priapism with delayed presentation.

Area of Science:

• Urology
• Vascular Surgery
• Emergency Medicine

Background:

• Priapism is an urgent urological condition classified as low-flow (ischaemic) or high-flow (non-ischaemic).
• Diagnosis involves clinical assessment, cavernosal blood gas sampling, and penile Doppler ultrasound.
• High-flow priapism management may include conservative treatment, surgery, or arterial embolisation.

Observation:

• A young man presented with high-flow priapism two weeks after perineal trauma.
• Penile Doppler ultrasound results were equivocal.
• Cavernosal blood gas sampling indicated arterial blood.

Findings:

• CT angiography identified an arteriovenous fistula as the cause of high-flow priapism.
• The patient underwent successful arterial embolisation.

Implications:

• Arterial embolisation is an effective treatment for high-flow priapism secondary to arteriovenous fistulas.
• This minimally invasive approach can successfully manage priapism post-trauma.
• Successful treatment preserves erectile function and sexual health.