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High-flow priapism is a rare condition in the form of priapism unrelated to sexual stimulation. The disease causes a decline in quality of life and has the risk of causing long-term erectile dysfunction if not treated promptly. We report a case of a 48-year-old male patient with prolonged high-flow erection after trauma who received endovascular intervention with n-butyl-2 cyanoacrylate biological glue. Results after 40 days of intervention and use of sildenafil 25 mg/day, the patient has an erection and has normal sexual activity. Cavernous arteriovenous fistula causing priapism with high flow is a rare condition. Computed tomography helps supplement information about feeding vessels as well as accompanying injuries for comprehensive assessment before treatment. Currently, there are many treatment methods, but transcatheter arterial embolization is modality of choice for achieve clinical efficacy and can safely and flexibly reduce the risk of secondary erectile dysfunction.

High-flow priapism is an uncommon condition typically resulting from penile or perineal trauma, due to laceration of cavernosal artery. We present a case of 24-year-old male who presented with post-traumatic painless priapism. Ultrasound showed hematoma with arterio-cavernosal fistula. On CT Angiogram, the cavernosal artery was seen arising from accessory pudendal artery, which arose from inferior epigastric artery (IEA), branch of external iliac artery (EIA). Catheter angiogram of EIA showed fistulous communication at the base of the penis from a branch of IEA. Selective embolisation of the artery was done using 33% glue (n-butyl cyanoacrylate). Post embolisation, no residual filling of the fistula and partial detumescence of penis was noted. Transarterial embolisation is usually preferred as first line of management in high-flow fistulous priapisms. [ABSTRACT FROM AUTHOR]

Key Clinical Message: High‐flow priapism in pediatric population is rare, yet comprehensive clinical evaluation, along with penile Doppler ultrasound, and cavernosal blood analysis are crucial for accurate diagnosis. Conservative therapy is effective as an initial treatment. High‐flow priapism is considerably rare in the pediatric age group. We report a four‐month‐old infant presented with a prolonged penile erection. Diagnostic confirmation was achieved through the utilization of Doppler ultrasound and cavernous blood gas analysis. We also review published data on the management of this condition. [ABSTRACT FROM AUTHOR]

Copyright of Urologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Key Clinical Message High‐flow priapism in pediatric population is rare, yet comprehensive clinical evaluation, along with penile Doppler ultrasound, and cavernosal blood analysis are crucial for accurate diagnosis. Conservative therapy is effective as an initial treatment. Abstract High‐flow priapism is considerably rare in the pediatric age group. We report a four‐month‐old infant presented with a prolonged penile erection. Diagnostic confirmation was achieved through the utilization of Doppler ultrasound and cavernous blood gas analysis. We also review published data on the management of this condition.

Nonischemic priapism is a rare, painless, and nonurgent type of priapism which is usually related to a history of perineal trauma. It can be distinguished from ischemic priapism by history taking and oxygenated, nonacidotic blood in cavernous blood gas analysis. The diagnosis is further confirmed by elevated cavernosal artery blood flow under color Doppler ultrasound. This article reviews the diagnosis and intervention of two cases with nonischemic priapism. The patients received selective arterial embolization with either microcoil or Gelfoam. Both of them were satisfied with their erectile function 1 week after embolization. Our practice reflects that selective arterial embolization is a safe and effective treatment for patients with nonischemic priapism.

Priapism is a persistent penile erection lasting more than four hours without sexual arousal or stimulation. We report on a high-flow priapism, an uncommon arteriovenous fistula of the corpus cavernosum after a straddle trauma which was successfully embolized. At follow up no recurrent episodes of priapism occurred without symptoms of erectile dysfunction or other complications.

High-flow priapism is a rare condition characterized by prolonged and painless erection. It is defined as contusion or thrombosis of the cavernous body of the penis usually secondary to blunt trauma. Due to the rarity of the disease, there is no well-defined consensus about treatment. Conservative treatment is often applied with non-steroidal anti-inflammatory drug. We present a case of 58-year-old man with proximal partial priapism that developed secondary to blunt trauma to the penis. The patient did not benefit from non-steroidal anti-inflammatory drug therapy and then was successfully treated with selective embolization. [ABSTRACT FROM AUTHOR]

Nonischemic priapism is a rare, painless, and nonurgent type of priapism which is usually related to a history of perineal trauma. It can be distinguished from ischemic priapism by history taking and oxygenated, nonacidotic blood in cavernous blood gas analysis. The diagnosis is further confirmed by elevated cavernosal artery blood flow under color Doppler ultrasound. This article reviews the diagnosis and intervention of two cases with nonischemic priapism. The patients received selective arterial embolization with either microcoil or Gelfoam. Both of them were satisfied with their erectile function 1 week after embolization. Our practice reflects that selective arterial embolization is a safe and effective treatment for patients with nonischemic priapism. [ABSTRACT FROM AUTHOR]

Priapism is a prolonged penile tumescence or erection unrelated to sexual stimulation that lasts more than 6 h. High-flow priapism is a rare condition usually due to a perineal trauma with the formation of an arterio-cavernosal fistula between a cavernosal artery and the lacunar spaces of the penis. High-flow priapism is usually diagnosed by clinical examination and color Doppler ultrasound, and the gold standard therapeutic management is represented by digital subtraction angiography. We report a case of a young patient with high-flow priapism after a motorcycle blunt perineal trauma, examining in detail the specific color Doppler ultrasound findings, the diagnostic workup and the therapeutic management. [ABSTRACT FROM AUTHOR]

Priapism is a medical condition characterized by a prolonged period of penile rigidity in the absence of external sexual stimulation. Three broad categories exist for this condition: ischemic (low venous flow), nonischemic (high arterial flow), and recurrent (stuttering). Ischemic priapism is a urological emergency necessitating immediate medical attention. This literature aims to highlight the importance of prompt workup and treatment of ischemic priapism in order to prevent irreversible damage to the penis, such as erectile dysfunction and impotence. This case report presents a 35-year-old patient who developed refractory ischemic priapism in the absence of an underlying causative agent. Fortunately, through pharmacological and surgical interventions, the patient was successfully treated with complete resolution of his symptoms., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Mount Sinai Hospital IRB issued approval MSH-IRB-24-8. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Desai et al.)

High-flow, or nonischemic, priapism occurs in

Priapism is defined as an erection lasting for more than 4 hours without sexual stimulation. It is grouped into 3 subtypes: ischemic (low-flow), nonischemic (high-flow), and stuttering priapism. Herein we describe a rare event of high-flow state as a result of conversion from a delayed ischemic priapism after a T-shunt with tunneling. To our knowledge, there is a paucity of reported cases, and the pathophysiology is still unclear. Clinicians should be aware of this uncommon but known scenario in case of penile tumescence after shunting procedure for ischemic priapism; penile Doppler ultrasound and selective pudendal angiography represent essential tools for diagnosis and treatment of this rare condition. In delayed ischemic priapism persisting for >36 hours, patients should be counseled about the irreversible damages of the cavernosal muscle and erectile dysfunction to consider an early penile prosthesis implantation with a satisfactory long-term functional outcome, decreasing the risks related to a distal shunt procedure. [ABSTRACT FROM AUTHOR]

A case of high-flow priapism was presented. Diagnosis was based on the history of painless and persistent erection for 20 days. Cavernous blood gas showed arterial type. The arteriocavernous fistula was detected by either a perineal duplex Doppler ultrasonography or an internal pudendal arteriography. The treatment of choice was selective embolization with a good result and no immediate complication. Detumescence was noticed within 10 days. Follow up of perineal and penile duplex Doppler ultrasonographies showed no turbulent flow and low inflow of cavernous blood. Erectile function partially recovered at 2 months after the treatment.

Le priapisme artériel est une pathologie rare mais classique dont l'étiologie principale est le traumatisme périnéal suite à une chute à califourchon. Ce traumatisme est responsable d'une lésion vasculaire d'une artère caverneuse ou d'une de ses branches conduisant à une fistule artériocaverneuse et une dérégulation du flux artériel des corps caverneux. L'érection est le plus souvent incomplète et non douloureuse. La prise en charge n'est pas urgente mais doit être planifiée afin de ne pas compromettre la fonction érectile future. Dans un premier temps, le traitement est conservateur par compression échoguidée du faux-anévrysme et glaçage du périnée. En cas d'échec, un traitement par radiologie interventionnelle par une équipe spécialisée doit être proposé. High-flow priapism is a rare but classic pathology whose main etiology is perineal trauma. This trauma is responsible for a vascular lesion of a cavernous artery or one of its branches, leading to an arteriocavernous fistula and arterial blood flow dysregulation in the corpora cavernosa. The erection is often incomplete and nonpainful. Its management is not a medical emergency but must be planned so as not to compromise future erectile function. It is based initially on a conservative treatment that consist on ultrasound-guided compression of the lesion and frosting of the perineum. In the event of treatment failure, interventional radiology by a specialized team should be proposed. [ABSTRACT FROM AUTHOR]

Purpose: High-flow priapism is an incomplete and painless persistent erection caused by trauma. Its diagnosis is performed thanks to clinic and imaging evaluation with detection of fistula/pseudoaneurysm in the cavernous tissue. This paper aims to retrospectively assess the efficacy and safety of superselective arterial embolization in patients with high-flow priapism. Materials and methods: From January 2008 to March 2017, nine patients with high-flow priapism have been treated in a single center with embolization. The main etiology was trauma in eight subjects. The patients were evaluated with laboratory examinations and clinical and imaging findings (color Doppler ultrasonography and angiography). The mean follow-up time after embolization was 24 months. Results: Eleven procedures were performed in nine patients: two of them required a second treatment session because of recurrence after 1–2 weeks. Embolic agents were microcoils, microparticles (300–500 μm) and Spongostan. Restoration of erectile function was monitored by clinical and color Doppler evaluation during follow-up. Conclusions: Superselective embolization should be the procedure of choice in patients affected by high-flow priapism; this technique appears to be successful in preserving erectile function. The choice of the embolic agent is crucial, and it should be tailored for each patient. [ABSTRACT FROM AUTHOR]

High-flow, or nonischemic, priapism occurs in <5% of observed clinical presentations of all priapism and is characterized by prolonged, painless erection in the context of pelvic and genitourinary trauma. While conservative management can be safely attempted for many cases of high-flow priapism (HFP), selective embolization is becoming the preferred approach as it allows for rapid resolution. We, herein, present a case of a 42-year-old male patient who presented with trauma-induced HFP treated with selective embolization and briefly review the current literature regarding the management of HFP. [ABSTRACT FROM AUTHOR]

Summary: High‐flow priapism is a rare condition mainly caused by perineal trauma. Laceration of cavernosal artery results in a formation of arterial–lacunar fistula with unregulated blood flow causing prolonged erection. We present a case of a 25‐year‐old man with high‐flow priapism and concurrent erectile dysfunction treated with repeated selective embolisation with only a partial effect. When no further embolisation was possible, we assumed on conservative management even through the fistula was still present. Spontaneous detumescence occurred 9 months, and erectile function has fully restored 24 months after the injury. To the best of our knowledge, spontaneous detumescence with full restoration of erection even through the persistent arterial–lacunar fistula has not been reported previously. Therefore, we propose conservative approach after embolisation to be an option. [ABSTRACT FROM AUTHOR]

Introduction. High-flow priapism is a rare condition in children, usually due to a perineal trauma. Materials and methods. We present a case of traumatic highflow priapism investigated by Doppler ultrasound and managed by angiography and selective embolization of a branch of the internal pudendal artery. Results. A 13-year-old gymnast underwent perineal trauma during training and developed a high-flow priapism. The first ultrasound (immediately after the trauma) showed the presence of an inhomogeneous area of 3 x 2 cm associated with an anechoic vascularized area (pseudoaneurysm) in the right corpus cavernosum. On the left side there was a similar finding, but of smaller size. After 3 weeks the pseudoaneurysm on the left was completely obliterated while the right one was still present. Angiography and superselective catheterization of a branch of the left pudendal artery and its embolization with microspheres and with metal microcoils were performed. After the procedure, ultrasound showed that the right pseudoaneurysm was completely obliterated and there were no more branches reaching it. The cavernous arteries were both pervious. Conclusions. Selective arterial embolization is a safe treatment that can also be used in pediatric patients.

There are many treatment options in high-flow priapism. Those mentioned most often are watchful waiting, Doppler-guided compression, endovascular highly selective embolization, and surgery. We present a case of high-flow priapism in a 57-year-old man treated by percutaneous direct puncture embolization of a post-traumatic left cavernosal arteriovenous fistula using N-butyl-cyanoacrylate. Erectile function was preserved during a 12-month follow-up. No patients with percutaneous direct puncture embolization for high-flow priapism have been reported previously. Percutaneous direct puncture embolization is a potentially useful and safe method for management of high-flow priapism. [ABSTRACT FROM AUTHOR]

Priapism is characterized by involuntary persistent penile erection after or independent of sexual stimulation. The diagnostic clarification, including patient history, physical findings, duplex ultrasonography and analysis of blood gases is decisive for the underlying pathophysiology and the appropriate therapeutic procedure. Non-hypoxic and non-acidotic blood gas parameters enable a conservative approach, hypoxic, hypercarbic and acidotic parameters may lead to fibrosis of the corpora cavernosa and, in turn, to a loss of penile function. Low-flow or ischemic (veno-occlusive) priapism is an emergency situation and can lead to irreversible erectile dysfunction within 4 h. Treatment consists of blood aspiration and possibly intracavernosal injection of sympathomimetic drugs. A distal shunt is necessary in the case of treatment failure (in rare cases a proximal shunt). Management of recurrent priapism (stuttering) includes self-injection of sympathomimetic drugs and preventive long-term administration of erection inhibitory and erection promoting substances. This concept still needs to be validated. High-flow or non-ischemic priapism does not necessitate immediate treatment measures and should be kept under observation. In cases of a detectable fistula selective artery embolization is often a successful option. [ABSTRACT FROM AUTHOR]

Introduction. High-flow priapism (HFP) may occur secondary to perineal trauma, congenital arterial malformations, and iatrogenic insults. In cases that do not resolve spontaneously, standard management is by selective embolization, resulting in resolution rates as high as 78%; however, erectile dysfunction (ED) is a frequent complication, occurring in up to 39% of cases. Aim. We report our use of androgen blockade (AB) to suppress nocturnal erections as an alternative treatment for HFP. Methods. A retrospective review of all patients treated at our institution for HFP was undertaken. Included in this study were any patients treated with single- or combination-agent AB for HFP. Operative reports and medical records were examined to determine patient characteristics and outcomes. Treatment efficacy, side effects, and residual ED were assessed using a questionnaire. Main Outcome Measures. The primary clinical outcomes assessed were resolution of HFP, tolerability, and side effects of treatment. Results. Seven patients with HFP were treated with AB. Priapism was a result of trauma in three patients and a persistent high-flow state after shunt procedures in four. Mean follow-up was 2 years (range 4 to 64 months). Therapy consisted primarily of 7.5 mg intramuscular monthly leuprolide injections, although bicalutamide and ketoconazole were also utilized as adjunct treatments. Therapy duration ranged from 2 months to 6 months and was discontinued after symptom resolution. One patient discontinued daily ketoconazole after 1 week because of severe hot flashes. The remaining six patients reported complete resolution of HFP. The primary complaints during therapy were decreased libido and fatigue. All patients reported some degree of ED during therapy. There was no reported residual ED or other hypogonadal symptoms on withdrawal of therapy. Conclusion. AB is a successful option for treating HFP with acceptable side effects and return to baseline potency on treatment withdrawal. Mwamukonda KB, Chi T, Shindel AW, and Lue TF. Androgen blockade for the treatment of high-flow priapism. J Sex Med 2010;7:2532–2537. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report herein a case of a patient with high-flow priapism for whom a gelatin sponge was used as a temporary occlusive agent in arterial embolization, resulting in favorable outcome. The American Urological Association guideline on the management of priapism recommends using temporary occlusive agents. We reviewed all reports published after the introduction of this guideline to compare temporary and permanent occlusive agents in terms of symptom improvement and onset of erectile dysfunction. The rate of symptom improvement differed significantly between temporary and permanent embolizing materials, but no significant difference was apparent in the rate of erectile function improvement. [ABSTRACT FROM AUTHOR]

Abstract: High-flow priapism is an uncommon entity in the pediatric and adolescent population. It is usually caused by perineal trauma. Here we describe the experience of our institution in this condition over the past 10 years, the various treatment options available, and the successful application of super-selective angiographic embolization as our treatment modality of choice. Included here is the case of a 4-year–old boy (case 3) who, to our knowledge, is the youngest patient described with this condition in the literature. [Copyright &y& Elsevier]

Abstract: Priapism is rare in the paediatric population and hence there is little consensus as to appropriate management strategies. This is a report of a case of high-flow priapism in a 9-year-old boy managed expectantly. A review of the literature found 52 previously published cases. This report highlights the diagnostic problems and examines the safety and effectiveness of expectant management in the paediatric population. [Copyright &y& Elsevier]

The aim of this study was to report feasibility, benefit and complications of superselective transcatheter autologous clot embolizations and duplex sonography-guided compression therapy in four patients with delayed post-traumatic high-flow priapism. Medical records of four consecutive patients diagnosed with delayed post-traumatic high-flow priapism (arterial priapism) were reviewed. High-flow priapism occurred mean 41.8 (6–92) h after the trauma developed. The patients were presented to hospital mean 8.3 (5–15) days after priapism occurred. The patients were assessed by penile color flow Doppler sonography. After the pathologically increased, arterial flow or arteriocavernosal fistula was seen, combination therapy with superselective transcatheter autologous clot embolizations and duplex sonography-guided compression was performed. If complete detumescence could not be achieved, this therapy was applied in the following day. In patients who had resistance to the second embolization, superselective embolization with microcoil was performed. Follow-up included penile color flow Doppler sonography at the following day, 1 month and 3 months after the procedure. International Impotence Symptoms Score (IIEF) was obtained during the follow-up. The treatment was successful in one, partially successful in one and not successful in two of the four patients. This therapy was reperformed to the latter three patients. After the treatment, high-flow priapism disappeared in one of the three patients and embolization with methalic microcoil was needed to perform to the other two patients. At 1 day after the treatment, color flow Doppler sonography and physical examinations were normal in all four patients. In the 1st and 3rd months of the follow-up, color flow Doppler sonography and the NPT tests were normal in three of the four patients. Slight erectile dysfunction was detected in one patient. Combination of superselective transcatheter autologous clot embolizations and duplex sonography-guided compression therapy may be considered as one of the first-line treatment options in adult patients with delayed post-traumatic high-flow priapism.International Journal of Impotence Research (2006) 18, 141–145. doi:10.1038/sj.ijir.3901373; published online 4 August 2005 [ABSTRACT FROM AUTHOR]

Traumatic high-flow priapism caused by a pathologic influx from lacerated arteries to the cavernous bodies is usually treated by transcatheter arterial embolisation. The purpose of this study was to evaluate a combined interventional approach with intraoperative perineal colour Doppler ultrasound (US) while performing the embolisation procedure. Our aim was to reduce radiation exposure and application of iodinised contrast media. To achieve an optimal position of the angiography catheter directly before or in the fistula, instead of several x-ray examinations with contrast media, a perineal colour Doppler US examination was performed while saline or US contrast media were injected through the catheter. The flow pattern allows the assessment of the occlusion of the fistula and the intact flow in the arteries that were not damaged. In four patients (unilateral fistula: 1, bilateral fistulas: 3) with traumatic high-flow priapism, this technique was performed combined with a conventional angiographic control of the embolisation. Seven embolisation sessions were performed. Only in one case, a dislocation of a microcoil required a second session. In all cases, the priapism disappeared immediately after the final session, leading to a restored erectile function. This combined approach may reduce the exposure to radiation and contrast media, especially in children, who often suffer from multiple fistulas and need more than one session. The procedure also prevents an occlusion of intact arteries that affects the penile perfusion and increases the risk of erectile dysfunction. (E-mail:bjoern.volkmer@medizin.uni-ulm.de) [Copyright &y& Elsevier]

Priapism is caused by an imbalance between penile blood inflow and outflow. There are two types of priapism: low-flow priapism due to venous occlusion and high-flow priapism due to uncontrolled arterial flow to the veins. High-flow priapism most frequently occurs as a result of penile trauma in which the intercavernosal artery disruption causes an arteriocavernosal fistula. It is rarely encountered in the pediatric and prepubertal population. Clinically, it manifests as a painless, prolonged erection after perineal trauma. Treatment ranges from expectant management to open surgical exploration with vessel ligation. We report the successful treatment of high-flow priapism in a 12-year-old prepubertal boy with superselective embolization.

Priapism is defined as a prolonged penile erection in the absence of sexual stimulation. Priapism is divided into two types: low flow and high flow. Color doppler imaging plays an important role as a noninvasive method of diagnosing high-flow priapism caused by penile trauma. Two patients are presented with a history of penile trauma resulting in priapism. Abnormal increased flow in a resting state was demonstrated using color Doppler in each patient. This article reviews our experience, including methods for performing an effective ultrasound examination. [ABSTRACT FROM PUBLISHER]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

High-flow or arterial priapism is an uncommon condition resulting from perineal or penile trauma. The classical features are a painless erection of the cavernous bodies while the corpus spongiosum stays flaccid. This case highlights a 11-year-old boy who presented with painless semi rigid erection of 3 days duration following a blunt skateboard injury to his perineum. Following failed conservative treatment, the patient underwent bilateral internal pudendal angiography with localization and embolization. Follow up in 1 month showed patient to have normal nocturnal and reflexogenic erections. Medical and surgical treatments for high-flow priapism have been described in literature with varying degree of success and complications. The current accepted standard of care is pelvic angiography and super-selective embolization of internal pudendal artery. [ABSTRACT FROM AUTHOR]

We report a case of high-flow priapism treated successfully with superselective embolization of the cavernous artery. An 18-year-old man presented to our hospital 12 days after having been struck in the perineum by the corner of a skateboard. Immediately after the injury, he suffered painless sustained incomplete erection. High-flow priapism was diagnosed on the basis of cavernosal blood gas analysis and color Doppler ultrasonography findings. Right internal pudendal arteriography showed blood pooling in the cavernosum as a result of a broken artery. We identified the precise position of the arterial–venous fistula and embolized it superselectively with gelatin sponge particles. The fistula disappeared completely. One year later, the patient’s erectile function was completely restored, and there had been no recurrence of the priapism. According to the American Urological Association guidelines, conservative treatment should be attempted first for high-flow priapism. In our review of the literature, superselective arterial embolization could be an alternative treatment after more than 3 weeks of conservative treatment. [ABSTRACT FROM AUTHOR]

Introduction. High-flow priapism is a rare condition in children, usually due to a perineal trauma. Materials and methods. We present a case of traumatic highflow priapism investigated by Doppler ultrasound and managed by angiography and selective embolization of a branch of the internal pudendal artery. Results. A 13-year-old gymnast underwent perineal trauma during training and developed a high-flow priapism. The first ultrasound (immediately after the trauma) showed the presence of an inhomogeneous area of 3 x 2 cm associated with an anechoic vascularized area (pseudoaneurysm) in the right corpus cavernosum. On the left side there was a similar finding, but of smaller size. After 3 weeks the pseudoaneurysm on the left was completely obliterated while the right one was still present. Angiography and superselective catheterization of a branch of the left pudendal artery and its embolization with microspheres and with metal microcoils were performed. After the procedure, ultrasound showed that the right pseudoaneurysm was completely obliterated and there were no more branches reaching it. The cavernous arteries were both pervious. Conclusions. Selective arterial embolization is a safe treatment that can also be used in pediatric patients. [ABSTRACT FROM AUTHOR]

Introduction: Non-ischemic or high-flow priapism is derived from unregulated arterial inflow within the penis, which is significantly less common and, therefore, less well characterized than ischemic or low-flow priapism., Aim: We collected the most recent available data and summarized the findings., Methods: All literature related to non-ischemic priapism from 2000-2018 from several databases was reviewed, and 105 articles, including any relevant referenced articles, were ultimately included., Main Outcome Methods: We evaluated modality success rates, need for repeat procedures, and effects on erectile function., Results: 237 cases of non-ischemic priapism were evaluated. Approximately 27% of patients underwent observation or medical management as the first treatment modality, whereas 73% underwent intervention without observation or medical management beforehand. Angiographic embolization with temporary agents was the most common intervention and generally resulted in both moderate resolution of non-ischemic priapism and moderate preservation of baseline erectile function. Patients who underwent embolization with permanent agents experienced higher rates of resolution, as well as lower rates of erectile dysfunction (ED)., Conclusion: Most of the literature is in the form of case reports and small case series, thus limiting the quality and quantity of evidence available to draw decisive conclusions. However, from the available data, it is reasonable to presume that patients can undergo a trial of conservative management, then pursue embolization first with temporary agents. The analysis of the data demonstrated ED rates were higher with temporary agents than permanent agents. The literature quotes ED rates as low as 5% when using temporary agents and 39% with permanent agents. Our results were, in fact, the opposite, with higher ED rates when using temporary agents vs permanent (17-33% vs 8-17%). Further studies are required to better characterize the success and outcomes of angioembolization. Ingram AR, Stillings SA, Jenkins LC. An Update on Non-Ischemic Priapism. Sex Med Rev 2020;8:140-149., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)