POSTTRAUMATIC PRIAPISM TREATED WITH SELECTIVE CAVERNOSAL ARTERY LIGATION

Two cases of post-traumatic high-flow priapism after blunt trauma to t he penis are presented. Diagnosis of high-flow priapism was accomplish ed with the use of both color-flow Doppler ultrasound and arteriograph y, which demonstrated arteriocorporal fistulas. In each patient, angio graphic embolization was attempted but abandoned because the distal ar tery feeding the fistula could not be safely catheterized. Both patien ts were definitively treated with surgical ligation of the arterioveno us fistula, guided by intraoperative ultrasound. Operative management with arterial ligation provides a safe, selective, and effective alter native treatment to embolization. Two surgical approaches are discusse d, one extracorporal and the other transcorporal. We believe that alth ough transcorporal dissection poses increased risks, it is appropriate for arterial priapism of prolonged duration, especially if a well-for med vascular pseudocapsule is identified. (C) 1997, Elsevier Science I nc.