HIGH-FLOW PRIAPISM FOLLOWING BLUNT PERINE AL TRAUMA

We report 2 cases of high-flow priapism following perineal trauma. Dia gnosis included blood gas analysis from the corpora cavernosa and angi ography of the internal iliac arteries showing arteriocavernous fistul a in both patients. Treatment included superselective embolization of the involved arteries using a microspiral. The first patient was a 29- year-old man with priapism for 43 hours prior to admittance. Conservat ive treatment remained unsuccessful and embolization of both bulbouret hral arteries led to rapid recovery. At 6 months follow-up erectile fu nction was normal, In the second case, an Ii-year-old boy presented wi th priapism for 9 days. Conservative treatment failed and the angiogra m showed an injury of the right perineal artery. After embolization of this vessel and both bulbourethral arteries, the patient had immediat e detumescence. He made an uneventful recovery and erectile function w as normal at 4 months follow-up. Both cases demonstrate the benefit of angiography with potential superselective embolization in posttraumat ic high-flow priapism after unsuccessful conservative treatment.