BACKGROUND High flow priapism(HFP)is a rare type of priapism.Perineal trauma is the most common cause of HFP.Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula,whereas persistent irregular ...BACKGROUND High flow priapism(HFP)is a rare type of priapism.Perineal trauma is the most common cause of HFP.Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula,whereas persistent irregular arterial blood flow entering the corpora cavernosum can cause a persistent penile erection.The routine treatment of HFP focuses on addressing the abnormal penile erectile status and avoiding post-treatment erectile dysfunction.Interventional embolization is an important therapeutic modality for HFP,and bilateral embolization therapy is currently the most commonly used technique for patients with bilateral cavernous artery fistulas;however,unilateral embolization therapy has yet to be reported.CASE SUMMARY Herein,we report of the case of a 26-year-old Chinese male who presented with a persistent abnormal erection for 12 h after perineal impact injury.Medical history,cavernous arterial blood gas analysis and radiological examinations led to a diagnosis of HFP caused by bilateral cavernous artery fistulas.We performed routine conservative treatment(compression therapy and ice application)for the patient after admission;however,10 d later,his symptoms had not been relieved.After completion of the preoperative workup,right(severe side)selective perineal artery embolization was performed;the left cavernous artery fistula was left untreated.After postoperative continuation of conservative treatment for 72 h,the patient experienced complete penile thinning.The patient had no symptoms of erectile dysfunction over a follow-up period of 12 mo.CONCLUSION Compared with bilateral cavernous artery fistula embolization,we believe that unilateral cavernous artery fistula embolization can achieve positive clinical efficacy and reduce the risk of postoperative erectile dysfunction secondary to penile ischemia.展开更多
This study is aimed to evaluate the effectiveness and safety of the treatment of highflow priapism with superselective transcatheter embolization.From Sep.1999 to Jan.2013,six patients with high-flow priapism underwen...This study is aimed to evaluate the effectiveness and safety of the treatment of highflow priapism with superselective transcatheter embolization.From Sep.1999 to Jan.2013,six patients with high-flow priapism underwent superselective transcatheter embolization of the cavernous artery.Recurrence of priapism,and change in erectile function detected by nocturnal penile tumescence and rigidity（NPTR） test and the International Index of Erectile Function 5-item questionnaire（IIEF-5） were evaluated during a mean follow-up of 12 months.A single superselective transcatheter embolization was sufficient for complete resolution of priapism in the six patients.None of the patients had a relapse of priapism after embolization,and all the patients who had premorbid normal erectile function showed maintained potency with normal results of NPTR and a mean postoperative IIEF-5 score of 23.5（range 23 to 24） during the follow-up period.In conclusion,superselective transcatheter embolization is an effective and safe treatment method for high-flow priapism,and it can ensure a high level of preservation of premorbid erectile function.展开更多
基金Supported by Foundation of the General Hospital of Western Command,No.2021-XZYG-C04。
文摘BACKGROUND High flow priapism(HFP)is a rare type of priapism.Perineal trauma is the most common cause of HFP.Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula,whereas persistent irregular arterial blood flow entering the corpora cavernosum can cause a persistent penile erection.The routine treatment of HFP focuses on addressing the abnormal penile erectile status and avoiding post-treatment erectile dysfunction.Interventional embolization is an important therapeutic modality for HFP,and bilateral embolization therapy is currently the most commonly used technique for patients with bilateral cavernous artery fistulas;however,unilateral embolization therapy has yet to be reported.CASE SUMMARY Herein,we report of the case of a 26-year-old Chinese male who presented with a persistent abnormal erection for 12 h after perineal impact injury.Medical history,cavernous arterial blood gas analysis and radiological examinations led to a diagnosis of HFP caused by bilateral cavernous artery fistulas.We performed routine conservative treatment(compression therapy and ice application)for the patient after admission;however,10 d later,his symptoms had not been relieved.After completion of the preoperative workup,right(severe side)selective perineal artery embolization was performed;the left cavernous artery fistula was left untreated.After postoperative continuation of conservative treatment for 72 h,the patient experienced complete penile thinning.The patient had no symptoms of erectile dysfunction over a follow-up period of 12 mo.CONCLUSION Compared with bilateral cavernous artery fistula embolization,we believe that unilateral cavernous artery fistula embolization can achieve positive clinical efficacy and reduce the risk of postoperative erectile dysfunction secondary to penile ischemia.
基金partly supported by the National Natural Science Foundation of China(No.81370705 and No.81471450)
文摘This study is aimed to evaluate the effectiveness and safety of the treatment of highflow priapism with superselective transcatheter embolization.From Sep.1999 to Jan.2013,six patients with high-flow priapism underwent superselective transcatheter embolization of the cavernous artery.Recurrence of priapism,and change in erectile function detected by nocturnal penile tumescence and rigidity（NPTR） test and the International Index of Erectile Function 5-item questionnaire（IIEF-5） were evaluated during a mean follow-up of 12 months.A single superselective transcatheter embolization was sufficient for complete resolution of priapism in the six patients.None of the patients had a relapse of priapism after embolization,and all the patients who had premorbid normal erectile function showed maintained potency with normal results of NPTR and a mean postoperative IIEF-5 score of 23.5（range 23 to 24） during the follow-up period.In conclusion,superselective transcatheter embolization is an effective and safe treatment method for high-flow priapism,and it can ensure a high level of preservation of premorbid erectile function.
