HIGH-FLOW PRIAPISM - A SPECTRUM OF DISEASE

We describe 4 cases of high flow arterial priapism, ranging from 1 wee k to 3 years in duration. The mode of presentation, evaluation using a duplex scanner, treatment and ultimate resolution are discussed. In 1 patient treated with ice compression the erection subsided spontaneou sly. One patient underwent percutaneous embolization and achieved detu mescence. In 2 men a vascular pseudocapsule formed around the site of the ruptured cavernous artery that provided an important anatomical la ndmark for intraoperative localization. The ruptured branch of the cav ernous artery was ligated in an open procedure. Based on these cases a nd a review of the literature, we outline a modified diagnostic and th erapeutic approach for patients with high flow arterial priapism.