Priapism is an urgent urological condition with various causes, classified as low flow (ischaemic) or high flow (non-ischaemic). Diagnosis involves a detailed clinical history, examination, and investigations like cavernosal blood gas sampling and penile Doppler ultrasound. In high-flow priapism, CT angiography can identify sources of abnormal arterial blood flow. Management options include conservative treatment, surgery, or arterial embolisation.
This paper details a case of a young man who developed high-flow priapism two weeks after perineal trauma, with an inconclusive penile Doppler ultrasound. Cavernosal blood gas sampling indicated arterial blood, and CT angiography revealed an arteriovenous fistula. The patient was successfully treated with arterial embolisation, resulting in detumescence and preservation of sexual function.
