超选择阴部内动脉栓塞术治疗高血流性阴茎异常勃起

Successful treatment of posttraumatic high-flow priapism with superselective arterial embolization

目的分析2例外伤后高血流性阴茎异常勃起的治疗,提高高血流性阴茎异常勃起的诊断、处理能力。方法 2007年10月至2008年10月2例患者因尿道扩张及会阴部外伤后出现阴茎无痛性持续性勃起;经阴茎海绵体穿刺血气分析分析鉴别疾病类型,血常规、肝肾功能等检查排除其他致病因素,阴茎彩色超声多普勒及超选择性阴茎内动脉造影发现异常血流;采用阴茎海绵体穿刺放血、局部冰敷、持续阴茎内注射药物等保守治疗无效后行阴部内动脉栓塞术。结果 2例患者分别栓塞术后4d、2d阴茎疲软,随访6个月、12个月勃起功能正常,均无复发。结论阴茎穿刺血气分析、彩色超声多普勒及阴部内动脉造影术是诊断高血流性阴茎异常勃起的有效诊断方法,超选择阴部内动脉栓塞术具有良好的治疗效果。

Objective To discuss the treatment of high-flow priapism with superselective transcatheter embolization. Methods Between 2007 and 2009, 2 patients with posttraumatic high-flow priapism were retrospectively analyzed in the study. The diagnosis of two patients based on colour Doppler ultrasound, cavernous blood gas analysis with arterial blood saturation levels. After conservative treatment failed, superselective pudendal arteriography and the superselective transcatheter embolization was performed with Gelfoam for treatment of high-flow priapism. Results Detumescence occurred in a few days for two patients. Transient erectile dysfunction was observed in both cases. One year later, the erectile function of patients was completely regained, and no recurrence of the priapism was found. Conclusion Superselective arterial embolization could be a feasible treatment method for posttraumatic high-flow priapism. The penis blood gas analysis, color Doppler ultrasound, and pudendal artery angiography are effective diagnostic methods for high-flow priapism.