Department of Interventional Radiology, St George Hospital, Sydney, New South Wales, Australia.
Department of Interventional Radiology, Wollongong Hospital, Wollongong, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2023 Jun;67(4):412-420. doi: 10.1111/1754-9485.13482. Epub 2022 Oct 6.
High-flow priapism is a rare condition with limited data in the literature, particularly in Australia. There is therefore no clear consensus regarding treatment. We aim to present our institutional network experience in managing this condition over the last decade with super-selective gelatin sponge (Gelfoam) embolisation of the internal pudendal artery.
We retrospectively searched for and reviewed the patient records of all cases of priapism encountered within our multicentre institutional network over the last 10 years. Of these, the cases of high-flow priapism treated with embolisation were analysed in depth and compared with the current literature.
Overall, 93 patients in our network were diagnosed with priapism from 1 January 2012 to 1 January 2022. And 89 of these patients (96%) had low-flow priapism and four patients (4%) had high-flow priapism. Of these four patients, two were treated within our network with super-selective Gelfoam embolisation of the internal pudendal artery. Following embolisation, both patients achieved rapid detumescence and returned to baseline premorbid erectile function. There was no report of recurrence or erectile dysfunction on follow-up.
Super-selective embolisation of the internal pudendal artery should be considered as a treatment option for high-flow priapism, with Gelfoam as an appropriate temporary embolic agent of choice. We show that it was a safe and effective option for the patients treated in this series, enabling quick and long-term return to baseline erectile function. Our results support data provided by the limited number of cases in the literature.
高流量性阴茎异常勃起是一种罕见的疾病，文献中数据有限，特别是在澳大利亚。因此，对于其治疗方法尚未达成明确共识。我们旨在展示过去十年中，我们的机构网络在使用超选择性明胶海绵（Gelfoam）栓塞阴部内动脉治疗这种疾病方面的经验。
我们回顾性地搜索并审查了过去十年中我们多中心机构网络中遇到的所有异常勃起患者的病历。在这些患者中，对接受栓塞治疗的高流量性异常勃起病例进行了深入分析，并与当前文献进行了比较。
总体而言，我们的网络在 2012 年 1 月 1 日至 2022 年 1 月 1 日期间诊断了 93 例异常勃起患者，其中 89 例（96%）为低流量性异常勃起，4 例（4%）为高流量性异常勃起。这 4 例患者中有 2 例在我们的网络中接受了超选择性阴部内动脉 Gelfoam 栓塞治疗。栓塞后，这两名患者均迅速消肿，并恢复到发病前的勃起功能基线水平。在随访中没有复发或勃起功能障碍的报告。
超选择性阴部内动脉栓塞应被视为治疗高流量性异常勃起的一种治疗选择，Gelfoam 是一种合适的临时栓塞剂。我们证明，对于本系列中接受治疗的患者，这是一种安全有效的选择，能够快速且长期恢复到基线勃起功能。我们的结果支持文献中有限数量病例提供的数据。
