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Spontaneous detumescence and full restoration of erection in a patient with high‐flow priapism with persistent arterial–lacunar fistula after repeated selective embolisation—A case report
Authors:M. Čechová  R. Pádr  P. Hanek  M. Chocholatý
Affiliation:1. Department of Urology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic;2. Department of Radiology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic;3. Department of Urology, Regional Hospital P?íbram, Czech Republic
Abstract:High‐flow priapism is a rare condition mainly caused by perineal trauma. Laceration of cavernosal artery results in a formation of arterial–lacunar fistula with unregulated blood flow causing prolonged erection. We present a case of a 25‐year‐old man with high‐flow priapism and concurrent erectile dysfunction treated with repeated selective embolisation with only a partial effect. When no further embolisation was possible, we assumed on conservative management even through the fistula was still present. Spontaneous detumescence occurred 9 months, and erectile function has fully restored 24 months after the injury. To the best of our knowledge, spontaneous detumescence with full restoration of erection even through the persistent arterial–lacunar fistula has not been reported previously. Therefore, we propose conservative approach after embolisation to be an option.
Keywords:arterial‐lacunar fistula  conservative management  high‐flow priapism  persistent fistula
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