Electronic ISSN 2287-0237

VOLUME

POST-TRAUMATIC HIGH-FLOW PRIAPISM TREATED WITH GELATIN SPONGE EMBOLIZATION: A CASE REPORT

SEPTEMBER 2014 - VOL.8 | CASE REPORT

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. 

Keywords:

high-flow priapism, embolization, gelatin sponge

MEDIA
Figure 1:
Selective angiogram of the left internal pudendal artery in right anterior oblique view appears unremarkable.
Figure 2-3:
Selective angiogram of the right internal pudendal artery in left anterior oblique view shows blood pooling in the cavernosum secondary to arterio-corporal fistula. (see arrow).
Figure 4:
During gelatin sponge embolization. The gelatin sponge is impacted in the corpus cavernosum (see arrow).
Figure 5-6:
The selective angiogram of the right internal pudendal artery shows a complete occlusion of the arteriocorporal fistula (see arrow).
Table 1:
Review of high-flow priapism treated with percutaneous embolization.
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