High-flow priapism is characteristically diagnosed on clinical findings: a prolonged, non-painful erection with a delayed onset that develops after a penile or perineal trauma. If conservative measures fail arteriography is indicated, which shows a blush of extravasating contrast from an arterio-cavernous fistula (rarely, as in our case bilateral) that can be treated by embolization. The embolic agent is gelfoam or a microcoil. Bilateral embolization is indicated when unilateral treatment does not result in detumescence of the penis. When the embolization is done highly selective the risk of complications is low and the results on erectile function are good.
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Langenhuijsen, J., Reisman, Y., Reekers, J. et al. Highly selective embolization of bilateral cavernous arteries for post-traumatic penile arterial priapism. Int J Impot Res 13, 354–356 (2001). https://doi.org/10.1038/sj.ijir.3900758
- high flow
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