Embolization Treatment of High-Flow Priapism

Abstract

Priapism is prolonged erection that persists beyond or is unrelated to sexual stimulation. There are two main types of priapism: high flow and low flow. The treatment of priapism will differ depending on the diagnosis of these two different types. In particular, interventional radiology plays a key role in treating patients with high-flow priapism. This article will review the diagnosis and treatment of the high-flow priapism.

Keywords

priapism - embolization - erectile dysfunction - ischemic - nonischemic - interventional radiology

• References

• 1 Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R. Priapism: pathogenesis, epidemiology, and management. J Sex Med 2010; 7 (1, Pt 2) 476-500
• 2 Roghmann F, Becker A, Sammon JD , et al. Incidence of priapism in emergency departments in the United States. J Urol 2013; 190 (4) 1275-1280
• 3 Tay YK, Spernat D, Rzetelski-West K, Appu S, Love C. Acute management of priapism in men. BJU Int 2012; 109 (Suppl. 03) 15-21
• 4 Halls JE, Patel DV, Walkden M, Patel U. Priapism: pathophysiology and the role of the radiologist. Br J Radiol 2012; 85 (Spec No 1) S79-S85
• 5 Tripe J. Case of continued priapism. Lancet 1845; 2: 1274-1276
• 6 Hinman F. Priapism: report of cases and a clinical study of the literature with reference to its pathogenesis and surgical treatment. Ann Surg 1914; 60 (6) 689-716
• 7 Hinman Jr F. Priapism; reasons for failure of therapy. J Urol 1960; 83: 420-428
• 8 Garaffa G. Priapism. London: Springer-Verlag; 2013: 49-54
• 9 Burt FB, Schirmer HK, Scott WW. A new concept in the management of priapism. J Urol 1960; 83: 60-61
• 10 Dubocq FM, Tefilli MV, Grignon DJ, Pontes JE, Dhabuwala CB. High flow malignant priapism with isolated metastasis to the corpora cavernosa. Urology 1998; 51 (2) 324-326
• 11 Chan PT, Bégin LR, Arnold D, Jacobson SA, Corcos J, Brock GB. Priapism secondary to penile metastasis: a report of two cases and a review of the literature. J Surg Oncol 1998; 68 (1) 51-59
• 12 Lutz A, Lacour S, Hellstrom W. Conversion of low-flow to high-flow priapism: a case report and review (CME). J Sex Med 2012; 9 (4) 951-954 , quiz 955
• 13 Montague DK, Jarow J, Broderick GA , et al; Members of the Erectile Dysfunction Guideline Update Panel; American Urological Association. American Urological Association guideline on the management of priapism. J Urol 2003; 170 (4, Pt 1) 1318-1324
• 14 Levey HR, Segal RL, Bivalacqua TJ. Management of priapism: an update for clinicians. Ther Adv Urol 2014; 6 (6) 230-244
• 15 Huang YC, Harraz AM, Shindel AW, Lue TF. Evaluation and management of priapism: 2009 update. Nat Rev Urol 2009; 6 (5) 262-271
• 16 Donaldson JF, Rees RW, Steinbrecher HA. Priapism in children: a comprehensive review and clinical guideline. J Pediatr Urol 2014; 10 (1) 11-24
• 17 Hakim LS, Kulaksizoglu H, Mulligan R, Greenfield A, Goldstein I. Evolving concepts in the diagnosis and treatment of arterial high flow priapism. J Urol 1996; 155 (2) 541-548
• 18 White C, Gulati M, Gomes A, Rajfer J, Raman S. Pre-embolization evaluation of high-flow priapism: magnetic resonance angiography of the penis. Abdom Imaging 2013; 38 (3) 588-597
• 19 Keck B, Lotter G, Wieland WF , et al. Sonographic diagnosis of a posttraumatic arteriocavernosal fistula resulting in high-flow priapism. J Clin Ultrasound 2012; 40 (1) 60-62
• 20 Ciampalini S, Savoca G, Buttazzi L , et al. High-flow priapism: treatment and long-term follow-up. Urology 2002; 59 (1) 110-113
• 21 Savoca G, Pietropaolo F, Scieri F, Bertolotto M, Mucelli FP, Belgrano E. Sexual function after highly selective embolization of cavernous artery in patients with high flow priapism: long-term followup. J Urol 2004; 172 (2) 644-647
• 22 Volgger H, Pfefferkorn S, Hobisch A. Posttraumatic high-flow priapism in children: noninvasive treatment by color Doppler ultrasound-guided perineal compression. Urology 2007; 70 (3) 590.e3-590.e5
• 23 Towbin R, Hurh P, Baskin K , et al. Priapism in children: treatment with embolotherapy. Pediatr Radiol 2007; 37 (5) 483-487
• 24 Wear Jr JB, Crummy AB, Munson BO. A new approach to the treatment of priapism. J Urol 1977; 117 (2) 252-254
• 25 Kim KR, Shin JH, Song HY , et al. Treatment of high-flow priapism with superselective transcatheter embolization in 27 patients: a multicenter study. J Vasc Interv Radiol 2007; 18 (10) 1222-1226
• 26 Langenhuijsen JF, Reisman Y, Reekers JA, de Reijke Th M. Highly selective embolization of bilateral cavernous arteries for post-traumatic penile arterial priapism. Int J Impot Res 2001; 13 (6) 354-356
• 27 Kress O, Heidenreich A, Klose KJ, Wagner HJ, Alfke H. Superselective embolization with coils in high-flow priapism. Cardiovasc Intervent Radiol 2002; 25 (4) 326-329
• 28 Yesilkaya Y, Peynircioglu B, Gulek B, Topcuoglu M, Inci K. Autologous blood-clot embolisation of cavernosal artery pseudoaneurysm causing delayed high-flow priapism. Pol J Radiol 2013; 78 (2) 54-56
• 29 O'Sullivan P, Browne R, McEniff N, Lee MJ. Treatment of “high-flow” priapism with superselective transcatheter embolization: a useful alternative to surgery. Cardiovasc Intervent Radiol 2006; 29 (2) 198-201
• 30 Cohen GS, Braunstein L, Ball DS, Roberto PJ, Reich J, Hanno P. Selective arterial embolization of idiopathic priapism. Cardiovasc Intervent Radiol 1996; 19 (1) 47-49
• 31 Burnett AL, Sharlip ID. Standard operating procedures for priapism. J Sex Med 2013; 10 (1) 180-194