Superselective arterial embolization for patients with high-flow priapism: Results of follow-up for five or more years

Purpose: To retrospectively evaluate the long-term results of transcatheter arterial embolization for high-flow priapism. Material and Methods: The study comprised six patients with high-flow priapism treated by superselective embolization of the internal pudendal arteries at our institution. The cause of priapism was traumatic in five patients and idiopathic in one. Follow-up was >= 5 years in all cases. Results: A total of nine embolizations were performed in the six patients. Embolization was performed once in three patients, while repeated embolizations were performed in the remaining three. Eleven arteries were altogether treated. Embolic materials used were gelatin sponge in nine arteries, gelatin sponge and microcoils in one, and microcoils alone in one. Embolization of the internal pudendal arteries on both sides in one single session was performed in one patient. In one patient, complete occlusion of the pseudoaneurysm was not achieved. However, restoration of erectile function and detumescence were noted during follow-up. Complications during the procedure were not registered. At follow-up >= 5 years after successful embolization, all six patients experienced detumescence as well as normal erectile function. Conclusion: Superselective embolization of the internal pudendal artery is the procedure of choice for treatment of high-flow priapism.