RESUMO
High flow priapism is a prolonged, non-painful penile erection unrelated to sexual stimulation after penile or perineal trauma. We report a case of high-flow priapism treated successfully with superselective embolization. An 8-year-old boy presented to our hospital 9 days after having been struck in the perineum during a bicycle accident. After the injury, the patient suffered a painless prolonged erection. High flow priapism was diagnosed by cavernosal blood gas analysis and penile duplex doppler ultrasonography. We identified the position of the fistula and pseudoaneurysm with angiography and embolized the lesions super-selectively with an autologous blood clot, gel foam, and a microcoil, bilaterally. After 2 superselective embolizations, the patient had detumescence. This case shows that bilateral arterio-cavernosal fistulas can be successfully treated with superselective arterial embolization.
Assuntos
Criança , Humanos , Masculino , Falso Aneurisma , Angiografia , Gasometria , Fístula , Ereção Peniana , Períneo , Priapismo , Ultrassonografia Doppler DuplaRESUMO
High flow priapism is a prolonged, non-painful penile erection unrelated to sexual stimulation after penile or perineal trauma. We report a case of high-flow priapism treated successfully with superselective embolization. An 8-year-old boy presented to our hospital 9 days after having been struck in the perineum during a bicycle accident. After the injury, the patient suffered a painless prolonged erection. High flow priapism was diagnosed by cavernosal blood gas analysis and penile duplex doppler ultrasonography. We identified the position of the fistula and pseudoaneurysm with angiography and embolized the lesions super-selectively with an autologous blood clot, gel foam, and a microcoil, bilaterally. After 2 superselective embolizations, the patient had detumescence. This case shows that bilateral arterio-cavernosal fistulas can be successfully treated with superselective arterial embolization.