Successful Endovascular Microembolization for Post-Traumatic High-Flow Priapism: A Case Report

Area of Science:

• Urology
• Interventional Radiology
• Vascular Surgery

Background:

• High-flow priapism, a rare condition often caused by blunt penile or perineal trauma, involves an arterial-lacunar fistula.
• While conservative management is attempted, refractory cases necessitate intervention, historically involving high-risk surgical procedures.
• Endovascular techniques offer a novel, less invasive alternative for treating this condition.

Observation:

• A 51-year-old male presented with high-flow priapism secondary to blunt trauma.
• Angio-CT revealed contrast extravasation into the corpus cavernosum.
• Angiography confirmed a fistula between the left internal pudendal artery and the corpora cavernosa.

Findings:

• Successful endovascular microembolization of the arterial-lacunar fistula was achieved using microcoils.
• The patient experienced an uneventful recovery and was discharged.
• At 6-month follow-up, symptoms were resolved, with no erectile dysfunction or priapism recurrence.

Implications:

• Endovascular microembolization is a safe and effective treatment for post-traumatic high-flow priapism.
• This minimally invasive approach successfully preserves sexual function.
• It represents a significant advancement over traditional surgical interventions for this condition.