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.
high-flow priapism, embolization, gelatin sponge
10.31524/bkkmedj.2014.09.013