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High flow priapism following the insertion of an inflatable penile prosthesis mimicking autoinflation: a case report

International Journal of Impotence Research volume 36, pages 3–5 (2024)Cite this article

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Abstract

Penile prosthesis implantation is a surgical option for erectile dysfunction when other treatments fail or the patient prefers implantation. Although penile prosthesis is generally considered safe and effective, various complications have been reported in the literature. High-flow priapism, resulting from an arteriovenous fistula between the cavernosal artery and the corpora cavernosa, is a rare complication after penile prosthesis implantation. Managing the condition as autoinflation may lead to unfortunate complications. A 54-year-old male patient underwent a penile prosthesis implantation due to erectile dysfunction lasting for 5 years. Doppler ultrasound revealed arterial insufficiency that was refractory to oral and intracavernosal treatments. A 3-piece inflatable penile prosthesis (Coloplast – Titan) was implanted through a midline penoscrotal incision without any complications. The patient reported uncontrolled tumescence after activating the device, which led us to suspect autoinflation. The final diagnosis was high-flow priapism due to an arteriovenous fistula in the cavernosal artery. The patient was given an antiandrogenic medication and the prosthesis was deflated for 3 months. The fistula closed without any additional intervention. High-flow priapism is a rare but potential complication of penile prosthesis implantation. Careful evaluation and management of patients’ symptoms are necessary for diagnosing and treating this condition. This case highlights the importance of considering high-flow priapism as a potential cause of uncontrolled tumescence after penile prosthesis implantation and the possibility of successful non-surgical management.

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Fig. 1: Physical findings of the patient with uncontrolled tumescence after inflatable penile prosthesis implantation.
Fig. 2: Doppler evaluation after deflation of the prosthesis.

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The data generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Urology, University of Health Science, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey

    Caner Baran, Eren Gorkem Kutluturk & Alper Otunctemur

  2. Department of Urology, Section of Andrology, Istanbul Faculty of Medicine, Istanbul, Turkey

    Ates Kadioglu

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  1. Caner Baran
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  2. Eren Gorkem Kutluturk
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  3. Alper Otunctemur
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  4. Ates Kadioglu
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Contributions

CB and AK conceived and design the study; CB and EGK performed literature search and created draft; AK and AO revised and finalized draft; all authors have read and approved final manuscript.

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Correspondence to Caner Baran.

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The authors declare no competing interests.

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According to our institutional regulations, a single case report with no patient’s identifying information, neither a formal ethical approval nor the participants’ consent is required. All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Baran, C., Kutluturk, E.G., Otunctemur, A. et al. High flow priapism following the insertion of an inflatable penile prosthesis mimicking autoinflation: a case report. Int J Impot Res 36, 3–5 (2024). https://doi.org/10.1038/s41443-023-00776-4

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