Post traumatic penile arteriovenous fistula with high flow priapism

Case contributed by Ahmed Abd Allah
Diagnosis certain

Presentation

Pain in the genital area following blunt perineal trauma 20 days ago, the patient reported painless priapism and difficult micturition.

Patient Data

Age: 30 years
Gender: Male

Penile Doppler examination revealed:

  • the right corpora cavernosa shows a dilated vascular lake with turbulent flow and high flow velocity suggestive of arteriovenous fistula
  • the right cavernosal artery shows high peak systolic velocity, PSV = 47 cm/sec 

Case Discussion

High flow priapism is a rare type of priapism, and usually occurs several days or weeks after penile or perineal trauma with formation of an arterio-cavernosal fistula.

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