Superselective arterial embolization for patients with high-flow priapism: results of follow-up for five or more years.
ABSTRACT To retrospectively evaluate the long-term results of transcatheter arterial embolization for high-flow priapism.
The study comprised six patients with high-flow priapism treated by superselective embolization of the internal pudendal arteries at our institution. The cause of priapism was traumatic in five patients and idiopathic in one. Follow-up was > or = 5 years in all cases.
A total of nine embolizations were performed in the six patients. Embolization was performed once in three patients, while repeated embolizations were performed in the remaining three. Eleven arteries were altogether treated. Embolic materials used were gelatin sponge in nine arteries, gelatin sponge and microcoils in one, and microcoils alone in one. Embolization of the internal pudendal arteries on both sides in one single session was performed in one patient. In one patient, complete occlusion of the pseudoaneurysm was not achieved. However, restoration of erectile function and detumescence were noted during follow-up. Complications during the procedure were not registered. At follow-up > or = 5 years after successful embolization, all six patients experienced detumescence as well as normal erectile function.
Superselective embolization of the internal pudendal artery is the procedure of choice for treatment of high-flow priapism.
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ABSTRACT: To review our experience with embolic materials used in the selective arterial embolization of high-flow priapism and present the results of long-term follow-up. Eight patients with traumatic high-flow priapism were reviewed. The patients were evaluated with clinical findings, laboratory examinations, and imaging findings including color Doppler ultrasonography and angiography. Diagnostic angiography demonstrated a connection between the cavernosal artery and the corpus cavernosum. Fistulas were embolized using autologous blood clot, polyvinyl alcohol particles, detachable coils, or acrylic glue. One or more procedures per patient were needed to achieve success. Eleven embolization procedures were performed in eight patients. Immediate resolution of priapism was obtained after the procedures. Three patients (37.5%) had recurrence of priapism in the subsequent 1-3 weeks and required a repeat procedure. After the final procedures, all patients had complete resolution of priapism. Normal recurrence of erectile function was obtained in six of the patients (75%) after the final embolization. Selective arterial embolization is a useful therapeutic option in the management of patients with high-flow priapism. Various materials can be used successfully as embolizing agents in the procedures according to the patient's status.Diagnostic and interventional radiology (Ankara, Turkey) 10/2009; 15(3):215-20. · 1.10 Impact Factor