Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Changing diagnostic and therapeutic concepts in high-flow priapism

International Journal of Impotence Research volume 17, pages 109–113 (2005)Cite this article

Abstract

High-flow priapism (HFP) is defined as pathological increased arterial influx into the cavernosal bodies. Since 1960, 202 cases have been published in the literature. This study evaluates the effect of the changing diagnostic and therapeutic concepts. The data of 202 cases of HFP was evaluated regarding diagnostic and therapeutic procedures and long-term results. Success was defined as restored erectile function without recurrent priapism. The major etiology of HFP is trauma, especially in children or young adults; in older men, HFP is a rare event mainly caused by malignoma. Cavernosal blood-gas analysis, color-Doppler ultrasound and angiography were the most effective diagnostic tools to distinguish high- from low-flow priapism. The success rate was 20% for shunt operations and 89% for arterial embolization. In conclusion, embolization was effective in the majority of cases of traumatic HFP, while shunt surgery remained disappointing. For HFP caused by inherited diseases and malignoma conservative therapy is mandatory.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Burt FB, Schirmer HK, Scott WW . A new concept in the management of priapism. J Urol 1960; 83: 60–63.

    Article  CAS  Google Scholar 

  2. Hauri D, Spycher M, Bruehlmann W . Erection and priapism: a new physiopathological concept. Urol Int 1983; 38: 138–145.

    Article  CAS  Google Scholar 

  3. Miller ST, Rao SP, Dunn EK, Glassberg KI . Priapism in children with sickle cell disease. J Urol 1995; 154(2 Part 2): 844–847.

    Article  CAS  Google Scholar 

  4. Hakim LS et al. Evolving concepts in the diagnosis and treatment of arterial high flow priapism. J Urol 1996; 155: 541–548.

    Article  CAS  Google Scholar 

  5. Brock G, Breza J, Lue TF, Tanagho EA . High flow priapism: a spectrum of disease. J Urol 1993; 150: 968–971.

    Article  CAS  Google Scholar 

  6. Kolbenstvedt A, Egge T, Schultz A . Arterial high flow priapism role of radiology in diagnosis and treatment. Scand J Urol 1996; 179: 143–146.

    CAS  Google Scholar 

  7. Harmon WJ, Nehra A . Priapism: diagnosis and management. Mayo Clin Proc 1997; 72: 350–355.

    Article  CAS  Google Scholar 

  8. Kerlan RK, Gordon RL, LaBerge JM, Ring EJ . Superselective microcoil embolization in the management of high-flow priapism. J Vasc Interv Radiol 1998; 9: 85–89.

    Article  Google Scholar 

  9. Grace DA, Winter CC . An appraisal of management of twenty-three patients. J Urol 1968; 99: 301–310.

    Article  CAS  Google Scholar 

  10. Wheeler GW, Simmons CR . Angiography in post-traumatic priapism. A case report. Am J Roentgenol Radium Ther Nucl Med 1973; 119: 619–620.

    Article  CAS  Google Scholar 

  11. Persky L, Kursh E . Post-traumatic priapism. J Urol 1977; 118: 397–398.

    Article  CAS  Google Scholar 

  12. Wear Jr JB, Crummy AB, Munson BO . A new approach to the treatment of priapism. J Urol 1977; 117: 252–254.

    Article  Google Scholar 

  13. Wafula JM, Davies P . Treatment of spontaneous priapism by embolisation of internal pudendal artery. Br Med J (Clin Res Ed) 1981; 282: 363–364.

    Article  CAS  Google Scholar 

  14. MacErlean DP, McDermott E, Kelly DG . Priapism: successful management by arterial embolisation. Br J Radiol 1982; 55: 924–926.

    Article  CAS  Google Scholar 

  15. Belgrano E et al. Percutaneous temporary embolization of the internal pudendal arteries in idiopathic priapism: 2 additional cases. J Urol 1984; 131: 756–758.

    Article  CAS  Google Scholar 

  16. Puppo P et al. Angiographic treatment of high-flow priapism. Eur Urol 1985; 11: 397–400.

    Article  CAS  Google Scholar 

  17. Lue TF, Hellstrom WJ, McAninch JW, Tanagho EA . Priapism: a refined approach to diagnosis and treatment. J Urol 1986; 136: 104–108.

    Article  CAS  Google Scholar 

  18. Mizutani M, Nakano H, Sagami K, Nihira H . Treatment of post-traumatic priapism by intracavernous injection of alpha-stimulant. Urol Int 1986; 41: 312–314.

    Article  CAS  Google Scholar 

  19. Dewan PA, Tan HL, Auldist AW, Moss DI . Priapism in childhood. Br J Urol 1989; 64: 541–545.

    Article  CAS  Google Scholar 

  20. Walker TG et al. ‘High-flow’ priapism: treatment with superselective transcatheter embolization. J Urol 1990; 140: 129–132.

    Google Scholar 

  21. Witt MA et al. Traumatic laceration of intracavernosal arteries: the pathophysiology of nonischemic, high flow, arterial priapism. J Urol 1990; 143: 129–132.

    Article  CAS  Google Scholar 

  22. Sulke J, Kleinhans G, Pohl J, Holzknecht A . Post-traumatischer high-flow-priapismus. Akt Urol 1990; 21: 329–332.

    Article  Google Scholar 

  23. Steers WD, Selby Jr JB . Use of methylene blue and selective embolization of the pudendal artery for high flow priapism refractory to medical and surgical treatments. J Urol 1991; 146: 1361–1363.

    Article  CAS  Google Scholar 

  24. Wolf JS, Lue TF . High-flow priapism and glans hypervascularization following deep dorsal vein arterialization for vasculogenic impotence. Urol Int 1992; 49: 227–229.

    Article  Google Scholar 

  25. Dunn EK et al. Penile scintigraphy for priapism in sickle cell disease. J Nucl Med 1995; 36: 1404–1407.

    CAS  PubMed  Google Scholar 

  26. Baumgärtel M, Böhle A, Zwaan M, Jocham D . High-flow-priapismus nach stumpfem perinealen trauma. Akt Urol 1997; 28: 52–55.

    Article  Google Scholar 

  27. Dubocq FM et al. High flow malignant priapism with isolated metastasis to the corpora cavernosa. Urology 1998; 51: 324–326.

    Article  CAS  Google Scholar 

  28. Greschner M, Krautschick A, Alken P . High-flow priapism leading to the diagnosis of lung cancer. Urol Int 1998; 60: 126–127.

    Article  CAS  Google Scholar 

  29. Sancak T, Conkbayir I . Post-traumatic high-flow priapism: management by superselective transcatheter autologous clot embolization and duplex sonography-guided compression. J Clin Ultrasound 2001; 29: 349–353.

    Article  CAS  Google Scholar 

  30. Volkmer BG et al. High-flow priapism: a combined interventional approach with angiography and colour Doppler. Ultrasound Med Biol 2002; 28: 165–169.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, University of Ulm, Ulm, Germany

    R Kuefer, G Bartsch Jr, K Herkommer & B G Volkmer

  2. Department of Clinical Radiology, Faculty of Medicine, Westfälische Wilhelms-Universität Münster, Münster, Germany

    S C Krämer

  3. Department of Urology, Dr Horst Schmidt Klinik, Wiesbaden, Germany

    K Kleinschmidt

Authors
  1. R Kuefer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G Bartsch Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K Herkommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S C Krämer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K Kleinschmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B G Volkmer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B G Volkmer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kuefer, R., Bartsch, G., Herkommer, K. et al. Changing diagnostic and therapeutic concepts in high-flow priapism. Int J Impot Res 17, 109–113 (2005). https://doi.org/10.1038/sj.ijir.3901257

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901257

Keywords

This article is cited by

Search

Advanced search

Quick links