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High flow priapism after blunt perineal trauma: resolution with bucrylate embolization
E Alvarez Gonzalez1, M Pamplona, A Rodriguez
1Urology Service, Hospital 12 de Octubre, Madrid, Spain.
The Journal of Urology
|February 1, 1994
Summary
High-flow priapism caused by arteriovenous fistula can be effectively treated with super-selective embolization using bucrylate. This method successfully resolved the condition in two patients while preserving erectile function.
Area of Science:
- Urology
- Vascular Surgery
- Radiology
Background:
- High-flow priapism is a rare condition often resulting from perineal trauma leading to arteriovenous fistulas.
- Traditional management options for such fistulas can be invasive and may compromise erectile function.
Observation:
- Two male patients, aged 21 and 33, presented with high-flow priapism secondary to perineal injury-induced arteriovenous fistulas.
- Diagnostic workup included cavernous blood gas analysis, color Doppler ultrasound, and arteriography.
Findings:
- Super-selective embolization of the arteriovenous fistula using bucrylate provided a satisfactory resolution in both cases.
- Post-treatment follow-up at 24 and 30 months revealed normal erectile function in both patients.
- This represents a novel application of intracavernous bucrylate embolization for priapism with successful detumescence and preserved erectile function.
Implications:
- Intracavernous bucrylate embolization offers a minimally invasive and effective treatment for high-flow priapism secondary to arteriovenous fistulas.
- This technique demonstrates potential for preserving erectile function, a critical aspect of patient recovery.
- Further research and case studies are warranted to establish bucrylate embolization as a standard treatment modality.