A Case of High-Flow Priapism That was Initially Presented as Low-Flow Priapistic State

Sohn, Jung Hwan; Lee, Sung Han; O, Byung Gi; Han, Chang Koo; Chung, Woo Sik

Abstract

Two forms of priapism are known. The more common type, low-flow priapism, presents as a prolonged painful erection and is characterized by ischemia and a disordered veno-occlusive mechanism. The less common form, high-flow priapism, is characterized by absence of pain and ischemia and unregulated blood inflow from the artery to the cavernosal sinuses. Prompt relief of priapism is essential to prevent ischemia and fibrosis of the corpora with resultant impotence. According to the type of priapism, the therapeutic approach is different. We report a case of idiopathic priapism that was initially identified as low-flow priapism. However, during treatment, it was confirmed as high-flow priapism by the finding of an arteriocavernosal fistula on arteriography, and the abnormal erection subsided after arterial embolization. On arteriography, there was an aberrant artery from the right common penile artery, and we were able to seen an arterial blush from the aberrent artery to the right cavernosal base.