High-Flow Priapism:Management Experience with Microcoils:A Case Report

以微線圈治療高血流性持續性勃起的經驗：病例報告

蔡蕙怡(Huei-Yi Tsai) ； 吳定國(Ding-Kuo Wu) ； 王建國(Chien-Kao Wang) ； 劉金昌(Gin-Chung Liu) ； 石明誠(Paul Ming-Chen Shih)

《中華放射線醫學雜誌》 27卷5期 (2002/10) Pp. 267-271

摘要

本篇報告一例成年男性因外傷引起高血流性持續性勃起合併有動脈海綿體廔管及假性動脈瘤。我們以微線圈經由兩側海綿體動脈成功地栓塞。此病例特殊處在於栓塞後有較小的復發假性動脈瘤，但不影響病人的正常勃起能力，也沒有造成持續性勃起的再發生。病人又接受了第二次的栓塞治療，但是假性動脈瘤仍持續存在。距離第一次栓塞兩個月後，這個病人又恢復正常的性生活。因此我們認為復發的假性動脈瘤若未造成症況並不需要急著再做第二次的栓塞而應以追蹤為首要考量。此外這個病例又再一次見證了使用微線圈栓塞兩側海綿體動脈的安全性。

關鍵字

持續性勃起 ； 假性動脈瘤 ； 栓塞

並列摘要

Priapism is defined as a state of prolonged erec-tion of the penis, not related to sexual desire or stim-ulation. It can be classified as high-flow or low-flow depending on the status of the penile arterial blood flow. The more common type, low-flow priapism, is due to stasis and diminished blood efflux from the cavernous bodies;while the high-flow type reveals uncontrolled blood in-flow. Most cases of high-flow priapism are related to perineal trauma, such as a straddle-type injury, in which the corporal artery is compressed against the pubic bone.
We report an adult patient with high-flow pri-apism due to combination of arteriocavernous fis-tula and pseudoaneurysm after perineal trauma. The patient was initially treated by bilateral supers-elective microcoils embolizations. Detumescence was achieved within one hour. Unfortunately, a recur-rent pseudoaneurysm was present during follow-up examination. Second embolization with blood clots and Gelfoam pledgets was hence performed. The recurrent pseudoaneurysm remained identified after the second embolization;however,decreased in size. The patient had no any discomfort such as recurrent priapism with the existence of the smaller pseudoa-neurysm and he regained normal morning erection and normal sexual function two months after the first embolization.

並列關鍵字

priapism ； pseudoaneurysm ； embolization