RECANALIZATION OF EMBOLIZED CAVERNOSAL ARTERY: RESTORING POTENCY IN THE PATIENT WITH HIGH FLOW PRIAPISM

摘要: High flow priapism is an uncommon disease. Most cases are secondary to trauma. An arteriocavernous fistula caused by laceration of the cavernosal artery or one its branches most common cause this hemodynamic alteration. Immediate treatment with reduction abnormal arterial better possibly than other treatments. In addition, angiographic embolization safe, selective and affords return premorbid function and, therefore, it has been widely used. our patient we evaluated blood gas analysis, performed color Doppler ultrasonography angiography for diagnosis, superselective internal pudendal autologous clots. The was followed magnetic resonance imaging (MRI) 2 months after embolization. CASE REPORT A 17-year-old man presented a 7-day history sustained, painless incomplete erection that occurred 3 days blunt penile injury when he fell down on bicycle. did not subside drainage corpora cavernosa needle aspiration several irrigations 10 mg./ml. phenylephrine, which produced transient flaccidity, had elsewhere. When referred us, penis engorged no tenderness, except bruising. scan showed venous in corpora, turbulent pseudoaneurysm. Peak systolic velocity 30 cm. per second (end diastolic second) right 52 6 left before Blood analysis revealed high oxygen partial pressure tension (93.8%) saturation (97.1%). Superselective under local anesthesia clearly demonstrated extravasation consistent presence pseudoaneurysm from branch (fig. 1, A). ml. performed. Repeat contrast injections confirmed dramatic B). became gradually flaccid following 48 hours. During followup later, stated sexual arousal associated erections, were complete. Physical examination ring-like fibrotic mass base but lesion could be differentiated as whether tunica albuginea intracavernosum. Color injection intracavernosal vasoactive agents well circumscribed hypoechoic longer connected artery, there cystic 2,