Post‐traumatic high‐flow priapism: Management by superselective transcatheter autologous clot embolization and duplex sonography–guided compression

Sancak, Tanzer; Conkbayir, Işık

doi:10.1002/jcu.1047

Cited by 22 publications

(16 citation statements)

References 12 publications

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“…According to our opinion, it is among the first literatures dealing with combination therapy of superselective transcatheter autologous embolizations and three sessions of duplex sonography-guided compression therapy. 26 This method was not successful in two of the four patients. Embolization with methalic microcoil was performed on two patients who had resistance to the treatment.…”

Section: Discussionmentioning

confidence: 90%

“…8 Majority of the studies dealing with treatment of high-flow priapism consist of only one or two patients. 4,12,18,19,[23][24][25][26] Mabjeesh et al 12 described three sessions of color flow duplex-guided compression therapy before angiography in patients with post-traumatic highflow priapism. After this report, we have thought that this method might increase the success rate of the embolization by decreasing the arterial blood flow in the arteriocavernosal shunt and, therefore, facilities the thrombosis of arteriocavernous fistula, as shown before by Hood, in patient with high-flow priapism.…”

Section: Discussionmentioning

confidence: 99%

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Is the combination of superselective transcatheter autologous clot embolization and duplex sonography-guided compression therapy useful treatment option for the patients with high-flow priapism?

2005

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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.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Is the combination of superselective transcatheter autologous clot embolization and duplex sonography-guided compression therapy useful treatment option for the patients with high-flow priapism?

2005

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“…7 Treatments of this priapism include watchful observation, intracavernosal injection of phenylephrine or methylene blue, external compression of the perineum, duplex sonography-guided compression therapy, surgical ligation of the internal pudendal or cavernosal artery, microsurgical closure of the arterial fistula, and superselective embolization of the torn artery. [8][9][10][11][12][13][14] Diagnostic imaging tests for penile fractures include cavernosography, urethrography, sonography, and MRI. Many authors recommend using cavernosography and urethrography as the radiologic methods of choice for localizing the penile fracture.…”

Section: Discussionmentioning

confidence: 99%

Color Doppler sonographic findings in penile fracture

Kervancıoğlu

Özkur

Metin

2004

J of Clinical Ultrasound

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We performed color Doppler sonographic examination on 4 patients, 3 of whom had preliminary diagnoses of penile fracture and 1 of whom had undergone an operation due to penile fracture a year previously. Color Doppler sonography helped evaluate the relationships between the hematoma and the vascular structures and aided in differential diagnosis of the vascular injuries that may accompany tunical rupture (or have similar clinical presentations) and Mondor's disease; thus, this method has a crucial role in choosing the treatment approach. Color Doppler sonography may also assist in the follow-up of patients after surgical or conservative treatment.

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“…Conservative management including bed rest, ice pack and site-specifi c external compression to induce vasospasm and thrombosis of arteriolar-sinusoidal fi stulae have been reported to be effective [ 8 ] . The use of perineal and penile colour Doppler US to accurately localise the vascular lesion, makes external compression more precise [ 48,50 ] . However, these treatments may take days to weeks and are thus impractical [ 49 ] .…”

Section: Management Of Non-ischaemic Priapismmentioning

confidence: 99%