Treatment of High-flow Priapism with Superselective Transcatheter Embolization in 27 Patients: A Multicenter Study

Kyung Rae Kim, Ji Hoon Shin, Ho Young Song, Gi Young Ko, Hyun Ki Yoon, Kyu Bo Sung, Tae Young Ahn, Chang Won Kim, Young Hwan Kim, Heung Kyu Ko, Byung Kook Kwak, Hyung Jin Shim, Hwan Hoon Chung, Sung Wook Shin, Jae Ik Bae

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Abstract

Purpose: To evaluate the effectiveness and safety of treatment of high-flow priapism (HFP) with superselective transcatheter embolization at nine university hospitals. Materials and Methods: Between May 1994 and October 2006, 27 patients underwent superselective embolization of the cavernous artery for HFP. Trauma was apparent in 22 patients, there was self-administered intracavernosal injection for erectile dysfunction in two, and the remaining three did not recall any penile or perineal trauma. The embolic agents used were autologous blood clot (n = 12), gelatin sponge (n = 12), microcoils combined with gelatin sponge (n = 1), polyvinyl alcohol (n = 1), and N-butyl cyanoacrylate (n = 1). Recurrence of priapism and change in erectile function were evaluated during a mean follow-up of 13 months. Differences in results between patients treated with autologous blood clot versus gelatin sponge were statistically analyzed with use of the χ2 test. Results: In 24 of 27 patients (89%), a single embolization was sufficient for complete resolution of priapism. Repeat embolization was required in two patients (7%), and in the remaining patient (4%), shunt surgery was performed after embolization as a result of HFP coexisting with corporeal venoocclusive dysfunction. Eighteen of 23 patients (78%) who had premorbid normal erectile function showed maintained potency during the follow-up period. There was no significant difference affecting required repeat embolization (P = .537) and change in quality of erection (P = .615) during the follow-up period between the autologous blood clot and gelatin sponge treatment groups. Conclusions: Superselective transcatheter embolization in the treatment of HFP is effective and ensures a high level of preservation of premorbid erectile function.

Original languageEnglish
Pages (from-to)1222-1226
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume18
Issue number10
DOIs
Publication statusPublished - 2007 Oct

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Kim, K. R., Shin, J. H., Song, H. Y., Ko, G. Y., Yoon, H. K., Sung, K. B., Ahn, T. Y., Kim, C. W., Kim, Y. H., Ko, H. K., Kwak, B. K., Shim, H. J., Chung, H. H., Shin, S. W., & Bae, J. I. (2007). Treatment of High-flow Priapism with Superselective Transcatheter Embolization in 27 Patients: A Multicenter Study. Journal of Vascular and Interventional Radiology, 18(10), 1222-1226. https://doi.org/10.1016/j.jvir.2007.06.030