Priapism is an urgent urological condition with varied aetiology that may be classified as low flow (ischaemic) or high flow (non-ischaemic). Diagnosis requires detailed clinical history and examination combined with appropriate investigations such as cavernosal blood gas sampling and penile Doppler ultrasound. In the case of high-flow priapism CT angiography can identify sources of abnormal arterial blood flow and cases may be managed conservatively, with surgery or through arterial embolisation. We detail a case of a young man presented 2 weeks after perineal trauma with high-flow priapism with an equivocal penile Doppler ultrasound. Cavernosal blood gas sampling was consistent with arterial blood and CT angiography was performed showing an arteriovenous fistula. The patient was then successfully managed with arterial embolisation resulting in detumescence and preserving sexual function.
- Urological surgery
- Interventional radiology
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Contributors All authors were involved in the clinical care for the patient. MH documented the case details and prepared the manuscript. BC assisted with the acquisition of data and images and proofread the manuscript. MP provided guidance on manuscript conception and design and approved the final published version. RE provided guidance on manuscript conception and design.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.