High-flow priapism caused by a pseudoaneurysm and an arteriocavernosal fistula: clinical and radiological approach of 3 cases.

OBJECTIVE: We report three cases of high-flow priapism in three young patients who presented erectile dysfunction after perineal trauma. METHODS: Complete clinical evaluation, blood tests, color Doppler ultrasonography (US), arteriography and selective embolization were performed. RESULTS: The clinical history and physical assessment were compatible with high-flow priapism. Color Doppler US showed a pseudoaneurysm and an arteriocavernosal fistula, which was confirmed and embolized using arteriography. CONCLUSIONS: High-flow priapism has a characteristic clinical presentation and physical examination. The radiologist has an important role in the diagnosis and treatment of this pathology. Color Doppler US and arteriography are essential in the diagnosis and allow embolization of the vascular injury. Prognosis is usually good.

Priapismo arterial por pseudoaneurisma y fístula arteriocavernosa: manejo clínico y radiológico de tres casos / High-flow priapism caused by a pseudoaneurysm and an arteriocavernosal fistula: clinical and radiological approach of 3 cases

OBJETIVO: Describir tres casos de priapismo arterial en pacientes jóvenes que presentaban disfunción eréctil e historia de traumatismo previo. MÉTODOS: Se realizó historia clínica, analítica, ecografía doppler color de cuerpos cavernosos, arteriografía y embolización selectiva lesional. RESULTADOS: La historia y exploración clínicas eran concordantes con un priapismo arterial. En la ecografía doppler color de los tres casos se identificó un pseudoaneurisma y una fístula arteriocavernosa que se confirmó y embolizó mediante arteriografía. CONCLUSIONES: El priapismo de tipo arterial tiene una historia y exploración clínicas características. El papel del radiólogo en el diagnóstico y tratamiento de esta patología es fundamental. La ecografía doppler color y la arteriografía son pruebas diagnósticas de primer orden y permite la embolización selectiva de la lesión vascular de base. El pronóstico generalmente es bueno

OBJECTIVE: We report three cases of high-flow priapism in three young patients who presented erectile dysfunction after perineal trauma. METHODS: Complete clinical evaluation, blood tests, color Doppler ultrasonography (US), arteriography and selective embolization were performed. RESULTS: The clinical history and physical assessment were compatible with high-flow priapism. Color Doppler showed a pseudoaneurysm and an arteriocavernosal fistula, which was confirmed and embolized using arteriography. CONCLUSIONS: High-flow priapism has a characteristic clinical presentation and physical examination. The radiologist has an important role in the diagnosis and treatment of this pathology. Color Doppler US and arteriography are essential in the diagnosis and allow embolization of the vascular injury. Prognosis is usually good