Premium
Successful superselective arterial embolization for post‐traumatic high‐flow priapism
Author(s) -
Takao Tetsuya,
Osuga Keigo,
Tsujimura Akira,
Matsumiya Kiyomi,
omura Norio,
Okuyama Akihiko
Publication year - 2007
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2007.01574.x
Subject(s) - medicine , priapism , embolization , arterial embolization , surgery , fistula , perineum , penis , blood flow , bloodletting , radiology , alternative medicine , pathology
Abstract: We report a case of high‐flow priapism treated successfully with superselective embolization of the cavernous artery. An 18‐year‐old man presented to our hospital 12 days after having been struck in the perineum by the corner of a skateboard. Immediately after the injury, he suffered painless sustained incomplete erection. High‐flow priapism was diagnosed on the basis of cavernosal blood gas analysis and color Doppler ultrasonography findings. Right internal pudendal arteriography showed blood pooling in the cavernosum as a result of a broken artery. We identified the precise position of the arterial–venous fistula and embolized it superselectively with gelatin sponge particles. The fistula disappeared completely. One year later, the patient’s erectile function was completely restored, and there had been no recurrence of the priapism. According to the American Urological Association guidelines, conservative treatment should be attempted first for high‐flow priapism. In our review of the literature, superselective arterial embolization could be an alternative treatment after more than 3 weeks of conservative treatment.