Lee Yung-Chin, Shen Jung-Tsung, Shih Ming-Chen, Chen Chung-Chin, Chou Yii-Her, Huang Chun-Hsiung
Department of Urology, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2003 Feb;19(2):79-83. doi: 10.1016/S1607-551X(09)70453-X.
Priapism is a prolonged penile erection unrelated to sexual stimulation. High-flow arteriogenic priapism is uncommon and usually occurs after genitoperineal trauma, which may damage a feeding cavernosal artery, leading to an arteriovenous fistula and, occasionally, to an associated pseudoaneurysm. The defects rarely occur bilaterally. Herein, we report successful treatment of high-flow priapism secondary to a traumatic pseudoaneurysm fed from the bilateral cavernosal artery. Diagnosis was made after cavernosal blood gas analysis, color Doppler ultrasonography, and superselective angiography. Treatment consisted of superselective arterial embolization using metallic microcoils and resulted in simultaneous detumescence of the penis with no complications. The patient regained morning erection on the second postoperative day and erectile function remained normal 8 months after treatment. This case shows that bilateral arteriocavernosal fistulae can be successfully treated with superselective arterial embolization without affecting potency and highlights the importance of warning men about the possibility of developing high-flow priapism following a perineal trauma.
阴茎异常勃起是一种与性刺激无关的持续性阴茎勃起。高流量动脉性阴茎异常勃起并不常见，通常发生在生殖会阴创伤后，这种创伤可能会损伤供血的海绵体动脉，导致动静脉瘘，偶尔还会伴有假性动脉瘤。这种缺陷很少双侧发生。在此，我们报告了一例成功治疗继发于双侧海绵体动脉供血的创伤性假性动脉瘤的高流量阴茎异常勃起的病例。通过海绵体血气分析、彩色多普勒超声和超选择性血管造影进行诊断。治疗方法是使用金属微线圈进行超选择性动脉栓塞，结果阴茎同时消肿，无并发症。患者术后第二天恢复晨勃，治疗8个月后勃起功能仍正常。该病例表明，双侧海绵体动静脉瘘可通过超选择性动脉栓塞成功治疗，且不影响性功能，并强调了告知男性会阴创伤后发生高流量阴茎异常勃起可能性的重要性。
