Bălănescu R. 1, 2, Topor Laura 1, 2, Nechifor R. 3, Malureanu Daniela 1
1 “Grigore Alexandrescu” Clinical Emergency Hospital for Children
2 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
3 “Delta” Hospital, Bucharest, Romania
Abstract
Priapism is a rare entity in the pediatric population and represents a persistent, usually painful erection that lasts for more than 4 hours and occurs without sexual stimulation in all age groups including newborns. However, it usually affects men between the ages of 5 to 10 years and 20 to 50 years. Priapism is caused by an imbalance between penile blood inflow and outflow. There are two types of priapism, low-flow due to venous occlusion and high-flow priapism due to uncontrolled arterial flow to the veins. High-flow priapism most frequently occurs as a result of penile or perineal trauma in which the intercavernosal artery disruption causes an arteriocavernosal fistula. Treatment ranges from expectant management to open surgical exploration with vessel ligation. The major chronic morbidity associated with all types of priapism is persistent erectile dysfunction, impotence and psychogenic sexual aversion. We report a successful treatment of high-flow priapism in a 5-year-old boy with superselective transcatheter embolization of the fistula with platinum microcoil using a coaxial microcatheter.