Wang C C, Chen J H, Liu S P, Hung J J, Liang P C, Hsieh J T
Department of Urology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.
J Formos Med Assoc. 2000 Dec;99(12):952-4.
A 54-year-old man developed priapism shortly after a blunt perineal trauma. An arteriocavernous fistula caused the high-flow priapism, and was detected on both color Doppler sonography and selective phaloarteriography. Selective embolization of the left cavernous artery with Gelfoam was performed to seal the fistula, resulting in immediate detumescence. However, the penis remained firm despite returning to almost normal size. No fistula was detected by subsequent color Doppler sonography and phaloarteriography examination. Intracavernous irrigation with 200,000 U streptokinase was applied to treat residual firmness 2 weeks after embolization. Successful sexual intercourse was reported 3 months later. The combination of selective cavernous artery embolization and intracavernous streptokinase irrigation was effective for the treatment of the high-flow priapism in this case.
一名54岁男性在会阴部钝性创伤后不久出现阴茎异常勃起。动静脉瘘导致高流量性阴茎异常勃起，彩色多普勒超声和选择性阴茎动脉造影均检测到该瘘。用明胶海绵对左侧海绵体动脉进行选择性栓塞以封闭瘘，阴茎立即消肿。然而，尽管阴茎大小几乎恢复正常，但仍保持坚挺。随后的彩色多普勒超声和阴茎动脉造影检查未检测到瘘。栓塞2周后，采用20万单位链激酶海绵体内灌注治疗残留的坚挺状态。3个月后报告性交成功。在该病例中，选择性海绵体动脉栓塞和海绵体内链激酶灌注联合治疗高流量性阴茎异常勃起有效。
