Post-Traumatic High-Flow Priapism Treated with Gelatin Sponge Embolization: A Case Report
Main Article Content
Abstract
A 41-year-old male presented with a one week of ongoing priapism subsequent to an injury in a traffic accident (blunt perineal trauma). A selective arteriography of the right internal pudendal artery demonstrated an arterio-corporal fistula. A 2.8 French (2.8 Fr.) Renegade Microcatheter (Boston Scientific) was advanced proximal to the fistula over a 0.014 flexible guidewire. The fistula was then embolized with a gelatin sponge (gelfoam). Post embolization showed the closure of the fistula and significant detumescence. At 12 weeks later: there was no recurrence of priapism and the patient reported normal erectile function. Transarterial embolization appears to be a safe and effective treatment for managing patients with high-flow priapism.
Article Details
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
2. Huang YC, Harraz AM, Shindel AW, et al. Evaluation and management of priapism: 2009 update. Nat Rev Urol 2009;6:262–7.
3. Chadha DS, Sivaramakrishna B, Rastogi V. Microcoil embolization in post-traumatic high-flow priapism. J invasive cardiol 2011;23:E147-9.
4. Kim KR,Shin JH,Song HY,et al. Treatment of high-flow priapism with super selective transcatheter embolization in 27 patients: A multicenter study. J Vasc Interv Radiol 2007;18: 1222-6.
5. Ul Islam J, Browne R, Thornhill J. Mountain bikers priapism; a rare phenomenon: Ir Med J 2014;107:21-2.
6. Callewaert P, Stockx L, Bogaert G, et al. Post-traumatic high-flow priapism in a 6-year-old boy: management by percutaneous placement of bilateral vascular coils. Urology 1998; 52:134-7.
7. Mathias K, Jager H, Witkowski M, et al. High-flow priapism following blunt perineal trauma: Interventional therapy. Radiologe 1998;38:710-3.
8. Liu B, Xin ZC, Zou YH, et al. High-flow priapism: super selective cavernous artery embolization with microcoils. Urology 2008;72:571-3.
9. Hakim LS, Kulaksizoglu H, Mulligan R, Greenfield A, Goldstein I. Evolving concepts in the diagnosis and treatment of arterial high flow priapism. J Urol 1996; 155:541-8.
10. O’Sullivan P, Browne R, McEniff N, et al. Treatment of “high-flow” priapism with superselective transcatheter embolization: a useful alternative to surgery. Cardiovasc Intervent Radiol 2006;29:198-201.
11. Sandlera G, Chennapragadaa SM, Soundappana SS, et al. Pediatric high-flow priapism and super-selective angio-graphy -- an Australian perspective. J Pediatr Surg 2008; 43:1898–901.
12. Görich J, Ermis C, Krämer SC, et al. Interventional treat-ment of traumatic priapism. J Endovasc Ther 2002;9:614-7.
13. Savoca G, Pietropaolo F, Scieri F, et al. Sexual function after highly selective embolization of cavernous artery in patients with high flow priapism: long-term follow up. J Urol 2004;172: 644-7.
14. Rados M, Sunjara V, Sjekavica I, et al. Post-traumatic high-flow priapism treated by endovascular embolization using N-butyl-cyanoacrylate. Radio Oncol 2010;44:103-6.