Recurrent idiopathic high-flow priapism treated with selective arterial embolization after repeated initial treatments for low-flow priapism
DOI:
https://doi.org/10.5489/cuaj.1024Abstract
High-flow priapism is most often seen following perineal andpenile trauma. We report the case of a 32-year-old man whopresented with recurrent idiopathic priapism initially treated aslow-flow priapism on 8 previous emergency department visits.Pelvic angiography revealed an abnormal communication betweenthe left cavernosal artery and the left corpus cavernosum andled to the diagnosis of high-flow priapism. Treatment involvedembolization of the left common penile artery, which resultedin successful resolution of the recurrent priapism. Our patient’scase highlights the importance of an appropriate work-up, includingimaging, to distinguish high- and low-flow priapism and toprovide appropriate care.
Le priapisme à haut débit est le plus souvent observé après untraumatisme périnéal et pénien. Nous décrivons le cas d’un hommede 32 ans atteint de priapisme idiopathique récurrent traité audépart comme un priapisme à bas débit lors de 8 visites antérieuresau service des urgences. Une angiographie pelvienne a révéléun passage anormal entre l’artère caverneuse gauche et le corpscaverneux gauche et a mené au diagnostic de priapisme à hautdébit. Un traitement par embolisation de l’artère pénienne gauchea été réalisé, entraînant la disparition complète du priapisme récurrent.Ce cas illustre l’importance d’une analyse approfondie, notammentà l’aide d’épreuves d’imagerie, afin de distinguer les cas àhaut débit des cas à bas débit et de choisir les soins appropriés.
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