选择性阴部内动脉栓塞术对高流量阴茎异常勃起的治疗(附4例报告)

Successful Treatment of High-flow Priapism by Selective Arteriographic Embolization of the Pudendal Artery

目的: 探讨选择性阴部内动脉栓塞术治疗高流量阴茎异常勃起 (HFP)的疗效。 方法: 对 4例外伤后阴茎异常勃起病例进行彩色多谱勒检查,其中 1例为双侧动脉 海绵体瘘,另 3例为单侧。2例 (双侧及单侧各 1例 )接受了高选择性阴部内动脉造影术及可吸收性明胶海绵选择性阴部内动脉栓塞术;另 2例接受了保守治疗。 结果: 前 2例患者术后阴茎硬度明显减低, 2个月及 1年后随访性功能基本恢复正常,性交满意;后 2例患者阴茎勃起分别持续到就诊后 19d及 21d;随访其性功能均有不同程度的减退,性交不满意。 结论: 选择性阴部内动脉造影及栓塞术是治疗HFP比较有效、安全、可选择的方法。

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 sponge, while the other 2 cases received conservative treatment. Results: The former 2 cases effected an immediate recovery of the erectile function, able to perform normal sexual intercourse in approximately 2 months. But in the latter 2, follow-up revealed unsatisfactory potency. Conclusion: Superselective arteriographic embolization with Absorbable gelatin sponge can provide a safe, selective and effective treatment for HFP patients.