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Delayed high flow priapism: pathophysiology and management

R Ricciardi1, G M Bhatt, J Cynamon

  • 1Department of Sexual Dysfunction, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.

The Journal of Urology
|January 1, 1993
PubMed
Summary
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High flow arterial priapism, often post-traumatic, involves delayed onset due to arteriovenous fistulas. Management includes selective arterial ligation or spontaneous resolution, both yielding good erectile function recovery.

Area of Science:

  • Urology
  • Vascular Surgery
  • Trauma Surgery

Background:

  • High flow arterial priapism is a rare condition, often resulting from trauma.
  • Understanding its pathophysiology is crucial for effective management.

Observation:

  • Two cases of delayed onset, post-traumatic high flow arterial priapism were observed.
  • Both cases presented with angiographically confirmed arteriovenous fistulas within the corpus cavernosum.

Findings:

  • Case 1 involved selective cavernous artery ligation, while Case 2 resolved spontaneously.
  • Both management strategies resulted in an excellent return of premorbid erectile function.
  • The proposed pathophysiology involves intracavernous arterial injury, ischemic necrosis, delayed rupture, and unregulated blood flow.

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Implications:

  • Selective cavernous artery ligation offers precise, non-disruptive control of bleeding vessels.
  • This study highlights successful management options and elucidates the pathophysiological mechanism of this condition.
  • Further research into traumatic vascular injuries affecting erectile function is warranted.