Successful treatment of high-flow priapism by selective arteriographic embolization of the pudendal artery

Objective: To evaluate the diagnosis and treatment of high-flow priapism (HFP).

Methods: Four cases of HFP following blunt trauma to the penis or perinea underwent diagnostic examination by colour-flow Doppler ultrasound and/or superselective pudendal arteriography, which revealed bilateral arteriocorporal fistula in 1 case and monolateral in the other 3. Penile detumescence was obtained in 2 cases by superselective bilateral/monolateral arteriographic embolization of the pudendal artery with absorbable gelatin

Results: The former 2 cases effected an immediate recovery of the sponge, while the other 2 cases received conservative treatment. Erectile function, able to perform normal sexual intercourse in approximately 2 months. But in the latter 2, follow-up revealed unsatisfactory potency.

Conclusions: Superselective arteriographic embolization with absorbable gelatin sponge can provide a safe, selective and effective treatment for HFP patients.