Microcoil embolization of an arteriovenous fistula from the arteria bulbi penis to the corpus spongiosum penis in the treatment of erectile dysfunction: normal function regained immediately after intervention.

A 39-year-old man presented with erectile dysfunction that had persisted since its sudden onset 5 years ago. He exhibited none of the classic risk factors, and all attempts at medication had been unsuccessful. An ultrasound examination revealed the presence of an arteriovenous shunt in the corpus spongiosum penis. Selective digital subtraction angiography of the left internal pudendal artery showed an arteriovenous fistula from the arteria bulbi penis to the corpus spongiosum penis. The outflow of venous blood took place via the penile veins into the periprostatic vein plexus. Superselective catheterization of the arteria bulbi penis was performed with a 3 French coaxial catheter (Topaz Micro Coils; Micro Therapeutics, Inc, Irvine, CA) and it was occluded by inserting several platinum coils. 1 week after the procedure, the patient reported normal erectile function, which was subsequently maintained.