微圈栓塞海绵体动脉瘘治疗外伤性阴茎异常勃起的疗效评价

目的评价微弹簧圈超选择性栓塞治疗外伤性高流量性阴茎异常勃起的技术与疗效。方法2002年6月至2006年3月我科共收治典型高流量性阴茎异常勃起患者7例。所有患者均有会阴部外伤病史。彩色超声均诊断阴茎单侧海绵体动脉瘘,且均经血管造影证实。所有动脉海绵体瘘均经微导管超选择插管,微圈栓塞。栓塞术后即刻对患者阴茎勃起状态进行体检评价,并分别于术后3、6个月对患者进行彩色超声随访,对勃起功能则长期随访评价。结果超选择动脉插管及栓塞均获得成功。其中6例首次治疗即使用微圈栓塞,另1例是在明胶海绵颗粒栓塞1周后复发,再次栓塞时使用的微圈技术。所有患者栓塞后即刻至1h检查,阴茎勃起状态明显消退。7例使用微圈栓塞患者长期随访阴茎勃起功能正常。结论超选择微圈栓塞对治疗高流量性阴茎异常勃起安全、有效。微圈应作为首选栓塞物取代传统的海棉颗粒。

Evaiuation of efficacy of microcoil for cavernous artery fistula embolization in traumatic high flow priapism

Objective To evaluate the effectiveness and techniques of superselective cavernous artery embolization with microcoils for the treatment of high-flow priapism. Methods From June 2002 through March 2006, 7 patients with typical priapism caused by pelvic trauma were presented in my department with age from 22 to 43 years old (mean 26). The unilateral arterial cavernosal fistula was identified by Duplex ultrasound and selective angiography in each patient and followed by selective occlusion with microcoils. The priapism was evaluated by physical examination after the procedure and the patients were followed up by Duplex ultrasound and the IIEF-5 questionnaire 3 and 6 months after the embolization. Results Superselective embolization was successfully accomplished in all cases including 6 with primary microcoils embolization and 1 secondarily with coils after recurrence with gelfoam particle embolization one week afterwards. All the 7 patients embolized with microcoils showed normal erectile function on follow-up. Conclusion Superselective embolization with micro-coils is a safe and effective procedure in the treatment of high-flow priapism and the microcoils should be the first choice instead of Gelfoam particles.