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[High-flow priapism after perineal trauma]

C Cabezas Checci1, L Fariña, L Martínez Carrancio

  • 1Servicio de Urología, POVISA, Vigo, Pontevedra.

Actas Urologicas Espanolas
|July 11, 1998
PubMed
Summary

A 19-year-old man experienced high-flow priapism after mountain biking. Selective arterial embolization successfully restored normal erectile function, offering a treatment option for this rare condition.

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Area of Science:

  • Urology
  • Vascular Surgery
  • Trauma Surgery

Background:

  • Post-traumatic high-flow priapism is a rare condition often resulting from injury to the penile vasculature.
  • It is characterized by persistent, non-ischemic penile erection due to abnormal arteriovenous shunting.
  • Diagnosis requires specialized imaging and laboratory tests to confirm the abnormal blood flow.

Observation:

  • A 19-year-old male presented with high-flow priapism following a mountain biking accident.
  • Clinical examination and diagnostic studies, including cavernous blood gas analysis, Doppler ultrasound, and internal pudendal artery arteriography, confirmed the diagnosis.
  • The patient experienced persistent, painful erections unrelated to sexual stimulation.

Findings:

  • Diagnostic imaging revealed an arteriovenous fistula in the internal pudendal artery, consistent with high-flow priapism.

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  • Laboratory tests indicated a high-flow state within the corpora cavernosa.
  • Selective percutaneous arterial embolization using an autologous blood clot was performed to occlude the abnormal shunt.

    • Implications:

    • Successful embolization led to complete resolution of priapism and restoration of normal erectile function.
    • This case highlights the efficacy of selective arterial embolization as a minimally invasive treatment for post-traumatic high-flow priapism.
    • The findings suggest that prompt diagnosis and intervention can prevent long-term complications and preserve sexual health in affected individuals.