Posttraumatic nonischemic priapism treated with autologous blood clot embolization

Furuzan Numan, Murat Cantasdemir, Mustafa Ozbayrak, Oner Sanli, Ates Kadioglu, Aylin Hasanefendioglu, Ahmet Bas

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Introduction. High-flow arterial priapism is rare and characterized by a prolonged nonpainful erection. Autologous clot embolization allows complete resolution of the problem in most of the cases. Aim. To review our experience with superselective transcatheter embolization in the treatment of nonischemic priapism. Main Outcome Measures. Advances in the understanding of the nonischemic priapism with the aid of newer techniques have altered the current management of nonischemic priapism. Materials and Methods. Between 2002 and 2006, 11 patients underwent superselective transcatheter embolization of nonischemic priapism with blunt trauma to the penis or perineum. All patients underwent diagnostic evaluation with color-flow Doppler ultrasound and superselective pudendal arteriography, revealing bilateral arteriocorporal fistula and pseudoaneurysm in two cases, bilateral arteriocorporal fistula in one case, unilateral arteriocorporal fistula in one case, and unilateral arteriocorporal fistula and pseudoaneurysm in seven cases. Autologous blood clot was used as an embolization agent in all cases combined with microcatheter guidance. Results. The procedure was technically successful in all cases. In three (27.2%) cases, a second embolization was required due to recurrence of priapism. In all patients, erectile function was restored within 6 weeks of the procedure. Follow-ups at 6 and 12months after the last procedure revealed that full erectile capacity was restored in 10 of 11 patients, and these patients did not experience further recurrence of priapism. One patient reported a slight decrease in the quality of his penile erection. Conclusions. Our experience revealed that superselective transcatheter embolization and transient occlusion of the fistula with autologous blood clot is an effective therapy for the treatment of nonischemic priapism. Furthermore, recovery of erectile function due to recanalization of the occluded vessel occurred weeks after the procedure.

Original languageEnglish (US)
Pages (from-to)173-179
Number of pages7
JournalJournal of Sexual Medicine
Volume5
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Autologous blood clot
  • Embolization
  • Priapism

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology

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    Numan, F., Cantasdemir, M., Ozbayrak, M., Sanli, O., Kadioglu, A., Hasanefendioglu, A., & Bas, A. (2008). Posttraumatic nonischemic priapism treated with autologous blood clot embolization. Journal of Sexual Medicine, 5(1), 173-179. https://doi.org/10.1111/j.1743-6109.2007.00560.x