ED 32. Minimally invasive treatment of high-Flow priapism by superselective embolization of the pudendal artery

Objectives: To determine the effectiveness of Superselective Embolization of the Pudendal Artery for the treatment of high-flow priapism, we reviewed the case records of 6 patients who were examined by the Urologic Clinic in Peking University People’s Hospital from 2000 to 2009. High-flow or arterial priapism is a fairly rare dysfunction, generally resulting from penile or perineal trauma. In some cases, the etiology remains unknown.

Methods: Trauma was reported in all the 6 cases, and these patients underwent selective embolization during arteriography. Color Doppler ultrasonography was repeated at 1 day and 1 month after the operation. The determination of erectile function at a mean follow-up of 21 months (range 13 to 44) was performed using the International Index of Erectile Function.

Results: Postoperatively, color Doppler ultrasonography revealed the absence of recurrence in all the 6 patients. Fistula recurrence was not detected in the 6 patients treated with selective embolization. In one of these patients, a second embolization procedure was conclusive. Sexual function was completely preserved in 80% of patients.

Conclusions: Pudendal angiography with superselective embolization is the treatment of choice. It is well tolerated and ensures a high preservation of premorbid erectile function.