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Objective: Literature review about arterial priapism cases secondary to bilateral postraumatic arterial-lacunar fistula, with special attention to therapeutic management by bilateral supraselective embolization., Methods: Bibliographic search using MEDLINE. A new case of high flow priapism secondary to bilateral postraumatic arterial-lacunar fistula is reported., Results: There are a total of ten cases of arterial priapism secondary to bilateral postraumatic arterial-lacunar fistula. Only one patient was treated by embolization in two steps with reabsorbable material; non reabsorbable material was used for embolization in three patients; in four cases embolization was performed as a single procedure and the remainder two cases resolved spontaneously. Erectile function was recovered independently of the therapeutic option performed., Conclusions: Embolization in two steps with reabsorbable material has been postulated as the treatment for arterial priapism secondary to bilateral postraumatic arterial-lacunar fistula or in cases of high flow status and drepanocytosis which do not resolve with other therapeutic measures. Nevertheless, if supraselective embolization is performed, it could not be mandatory to follow this therapeutic criteria, as it is suggested by erectile function results obtained.

Objective: To review the literature on high flow priapism in children and analyze the etiology, pathophysiological mechanism, diagnostic tests, treatment and complications., Methods: The literature is reviewed and an additional case of posttraumatic arterial priapism in an 11 year-old boy treated at our hospital is presented., Results: 24 cases of high flow priapism in children were found; 18 had a history of genitoperineal trauma, 5 had sickle cell anemia and one child had Fabry's disease. Diagnosis was based on patient history, intracavernous blood gases and echo doppler findings. Fourteen patients with posttraumatic priapism, one patient with sickle cell anemia and the child with Fabry's disease were treated by pudendal arteriography with embolization. The immediate results and erectile function were good., Conclusions: Genitoperineal trauma is the most common cause of arterial priapism in children. High flow must be considered in children with sickle cell disease and priapism that do not respond to conventional treatment. Pudendal arteriography with embolization is the treatment of choice. Erectile function is recovered after treatment.