Post-traumatic high-flow priapism: management by superselective transcatheter autologous clot embolization and duplex sonography-guided compression.

High-flow priapism is caused by uncontrolled arterial inflow into the penis, often from direct arterial trauma. We report a case of arterial or high-flow priapism that was treated with a combination of selective transcatheter autologous clot embolization and duplex sonography-guided compression therapy. Sonography showed a pulsatile, anechoic area at the base of the penis inside the left corpus cavernosum after blunt perineal trauma, and color Doppler examination revealed an arteriosinusoidal fistula. Autologous clot embolization was only partially successful, and 3 sessions of ultrasound-guided compression therapy were necessary to achieve complete thrombus formation in the fistulous tract, which became isoechoic a day after compression therapy.