Postsurgical high flow priapism treated by transarterial embolizaton: a case report.

The authors report a case of painful priapism, caused by iatrogenic arterial injury from endoscopic internal urethrotomy procedure for stricture urethra, which increased blood circulation in the penis. On physical examination, there was sustained erection, turgid corpora, swelling of penis and prepuce and tenderness at the perineal area. Bilateral selective internal iliac angiograms showed a prominent right internal pudendal artery and deep penile artery terminating in an arterio-sinusoidal fistula. This case was treated by superselective arterial embolization with Gelfoam pledgets and the treatment was successfully carried out in one session. However the patient sill had erectile dysfunction for six months. After that, the erectile dysfunction gradually improved. Finally, the patient had normal erectile function one year after embolization.