Андрология и генитальная хирургия. 2024; 25: 133-138
Эмболизация артериокавернозной фистулы при артериальном приапизме: клинический случай
https://doi.org/10.62968/2070-9781-2024-25-1-133-138Аннотация
Артериальный приапизм встречается гораздо реже венозного (неишемического, low-flow) приапизма. Учитывая отсутствие ишемии кавернозных тел при артериальном приапизме, экстренное оперативное вмешательство, как правило, не показано и допустима выжидательная тактика. При отсутствии самостоятельного разрешения артериального приапизма, желании пациента возможно выполнение инвазивного вмешательства. На данный момент методом выбора является суперселективная эмболизация ветвей внутренней половой артерии, кавернозной или спиральной артерии.
В данной статье представлен клинический случай артериального приапизма, при котором была выполнена суперселективная эмболизация кавернозной артерии эмболами PVA (поливиниловый спирт) с полным разрешением приапизма после операции.
Список литературы
1. С. В. Попов, И. Н. Орлов, Т. М. Топузов и др. Неишемический приапизм (посттравматическая артериовенозная фистула правого кавернозного тела) на фоне миопатии Ландузи-Дежерина // Урология. 2023. № 4. С. 117–120. DOI: 10.18565/urology.2023.4.117-120.
2. Ericson C, Baird B, Broderick GA. Management of Priapism. Urologic Clinics of North America. 2021;48(4):565-576. DOI: 10.1016/j.ucl.2021.07.003
3. Engel O, Bartsch G, Küfer R, Braun C, Hautmann RE, Volkmer BG. Geschichte des High-flow-Priapismus: 1960–2005. Urologe. 2006;45(3):351-355. DOI: 10.1007/s00120-005-0957-7
4. Burt FB, Schirmer HK, Scott WW. A New Concept in the Management of Priapism. Journal of Urology. 1960;83(1):60-61. DOI: 10.1016/S0022-5347(17)65655-6
5. Wear JB, Crummy AB, Munson BO. A New Approach to the Treatment of Priapism. Journal of Urology. 1977;117(2):252-254. DOI:10.1016/S0022-5347(17)58419-0
6. Kuefer R, Bartsch G, Herkommer K, Krämer SC, Kleinschmidt K, Volkmer BG. Changing diagnostic and therapeutic concepts in high-flow priapism. Int J Impot Res. 2005;17(2):109-113. DOI: 10.1038/sj.ijir.3901257
7. Milenkovic U, Cocci A, Veeratterapillay R, et al. Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism: a systematic review by the EAU Sexual and Reproductive Health Guidelines panel. Int J Impot Res. Published online September 23, 2022. DOI: 10.1038/s41443-022-00604-1
8. Bivalacqua TJ, Allen BK, Brock GB, et al. The Diagnosis and Management of Recurrent Ischemic Priapism, Priapism in Sickle Cell Patients, and Non-Ischemic Priapism: An AUA/SMSNA Guideline. Journal of Urology. 2022;208(1):43-52. DOI: 10.1097/JU.0000000000002767
9. Muneer A, Brown G, Dorkin T, et al. BAUS consensus document for the management of male genital emergencies: priapism. BJU Int. 2018;121(6):835-839. DOI: 10.1111/bju.14140
10. Shigehara K, Namiki M. Clinical Management of Priapism: A Review. World J Mens Health. 2016;34(1):1. DOI: 10.5534/wjmh.2016.34.1.1
11. Sandler G, Chennapragada SM, Soundappan SSV, Cass D. Pediatric high-flow priapism and super-selective angiography—an Australian perspective. J Pediatr Surg. 2008;43(10):1898-1901. DOI: 10.1016/j.jpedsurg.2008.05.027
12. Ciampalini S, Savoca G, Buttazzi L, et al. High-flow priapism: treatment and long-term follow-up. Urology. 2002;59(1):110-113. DOI: 10.1016/S0090-4295(01)01464-9
13. Lubarsky M, Ray C, Funaki B. Embolization Agents—Which One Should Be Used When? Part 1: Large-Vessel Embolization. Semin Intervent Radiol. 2009;26(04):352-357. DOI: 10.1055/s-0029-1242206
14. Liu B xing, Xin Z cheng, Zou Y hua, et al. High-Flow Priapism: Superselective Cavernous Artery Embolization with Microcoils. Urology. 2008;72(3):571-573. DOI:10.1016/j.urology.2008.01.087
15. Ierardi AM, Piacentino F, Fontana F, et al. The role of endovascular treatment of pelvic fracture bleeding in emergency settings. Eur Radiol. 2015;25(7):1854-1864. DOI: 10.1007/s00330-015-3589-3
16. Prattley S, Bryant T, Rees R. Superselective Embolization with Microcoil and Gelfoam for High-Flow Priapism Secondary to Bilateral Cavernous Fistulae: A Case Study. Case Rep Urol. 2019;2019:1-4. DOI: 10.1155/2019/3916056
17. Яровой С.К., Хромов Р.А., Джалилов О.В. Современные подходы к диагностике и лечению неишемического (артериального) приапизма. Research’n Practical Medicine Journal. 2017;4(4):99-109. https://DOI.org/10.17709/2409-2231-2017-4-4-11
18. С. К. Яровой, Р. А. Хромов, В. Н. Шиповский. Артериальный приапизм как осложнение ножевого ранения промежности // Урология. 2017. № 5. С. 86–90. DOI: 10.18565/urology.2017.5.86-90.
19. Munshi F, Kwon Y, Gibbens D, Mahmood P, Gazi M, Olweny E. High-flow priapism treated with selective embolization of a helicine branch of the penile artery: A case report and selected review of the literature. Urol Ann. 2020;12(1):103. DOI: 10.4103/UA.UA_45_19
20. Shapiro RH, Berger RE. Post-traumatic priapism treated with selective cavernosal artery ligation. Urology. 1997;49(4):638-643. DOI: 10.1016/S0090-4295(97)00045-9
21. Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R. Priapism: Pathogenesis, Epidemiology, and Management. J Sex Med. 2010;7(1):476-500. DOI: 10.1111/j.1743-6109.2009.01625.x
Andrology and Genital Surgery. 2024; 25: 133-138
Embolization of Arteriocavernous Fistula in Arterial Priapism: A Clinical Case
https://doi.org/10.62968/2070-9781-2024-25-1-133-138Abstract
Arterial priapism occurs much less frequently than venous (non-ischemic, low-flow) priapism. Considering the absence of ischemia of the cavernous bodies in arterial priapism, emergency surgical intervention is usually not indicated, and a wait-and-see approach is acceptable. In the absence of spontaneous resolution of arterial priapism, invasive treatment may be performed upon the patient’s desire. Currently, the method of choice is super-selective embolization of branches of the internal pudendal, cavernous, or helical artery. This article presents a clinical case of arterial priapism, in which super-selective embolization of the cavernous artery with PVA (polyvinyl alcohol) embolization agent was performed, resulting in complete resolution of priapism after the operation.
References
1. S. V. Popov, I. N. Orlov, T. M. Topuzov i dr. Neishemicheskii priapizm (posttravmaticheskaya arteriovenoznaya fistula pravogo kavernoznogo tela) na fone miopatii Landuzi-Dezherina // Urologiya. 2023. № 4. S. 117–120. DOI: 10.18565/urology.2023.4.117-120.
2. Ericson C, Baird B, Broderick GA. Management of Priapism. Urologic Clinics of North America. 2021;48(4):565-576. DOI: 10.1016/j.ucl.2021.07.003
3. Engel O, Bartsch G, Küfer R, Braun C, Hautmann RE, Volkmer BG. Geschichte des High-flow-Priapismus: 1960–2005. Urologe. 2006;45(3):351-355. DOI: 10.1007/s00120-005-0957-7
4. Burt FB, Schirmer HK, Scott WW. A New Concept in the Management of Priapism. Journal of Urology. 1960;83(1):60-61. DOI: 10.1016/S0022-5347(17)65655-6
5. Wear JB, Crummy AB, Munson BO. A New Approach to the Treatment of Priapism. Journal of Urology. 1977;117(2):252-254. DOI:10.1016/S0022-5347(17)58419-0
6. Kuefer R, Bartsch G, Herkommer K, Krämer SC, Kleinschmidt K, Volkmer BG. Changing diagnostic and therapeutic concepts in high-flow priapism. Int J Impot Res. 2005;17(2):109-113. DOI: 10.1038/sj.ijir.3901257
7. Milenkovic U, Cocci A, Veeratterapillay R, et al. Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism: a systematic review by the EAU Sexual and Reproductive Health Guidelines panel. Int J Impot Res. Published online September 23, 2022. DOI: 10.1038/s41443-022-00604-1
8. Bivalacqua TJ, Allen BK, Brock GB, et al. The Diagnosis and Management of Recurrent Ischemic Priapism, Priapism in Sickle Cell Patients, and Non-Ischemic Priapism: An AUA/SMSNA Guideline. Journal of Urology. 2022;208(1):43-52. DOI: 10.1097/JU.0000000000002767
9. Muneer A, Brown G, Dorkin T, et al. BAUS consensus document for the management of male genital emergencies: priapism. BJU Int. 2018;121(6):835-839. DOI: 10.1111/bju.14140
10. Shigehara K, Namiki M. Clinical Management of Priapism: A Review. World J Mens Health. 2016;34(1):1. DOI: 10.5534/wjmh.2016.34.1.1
11. Sandler G, Chennapragada SM, Soundappan SSV, Cass D. Pediatric high-flow priapism and super-selective angiography—an Australian perspective. J Pediatr Surg. 2008;43(10):1898-1901. DOI: 10.1016/j.jpedsurg.2008.05.027
12. Ciampalini S, Savoca G, Buttazzi L, et al. High-flow priapism: treatment and long-term follow-up. Urology. 2002;59(1):110-113. DOI: 10.1016/S0090-4295(01)01464-9
13. Lubarsky M, Ray C, Funaki B. Embolization Agents—Which One Should Be Used When? Part 1: Large-Vessel Embolization. Semin Intervent Radiol. 2009;26(04):352-357. DOI: 10.1055/s-0029-1242206
14. Liu B xing, Xin Z cheng, Zou Y hua, et al. High-Flow Priapism: Superselective Cavernous Artery Embolization with Microcoils. Urology. 2008;72(3):571-573. DOI:10.1016/j.urology.2008.01.087
15. Ierardi AM, Piacentino F, Fontana F, et al. The role of endovascular treatment of pelvic fracture bleeding in emergency settings. Eur Radiol. 2015;25(7):1854-1864. DOI: 10.1007/s00330-015-3589-3
16. Prattley S, Bryant T, Rees R. Superselective Embolization with Microcoil and Gelfoam for High-Flow Priapism Secondary to Bilateral Cavernous Fistulae: A Case Study. Case Rep Urol. 2019;2019:1-4. DOI: 10.1155/2019/3916056
17. Yarovoi S.K., Khromov R.A., Dzhalilov O.V. Sovremennye podkhody k diagnostike i lecheniyu neishemicheskogo (arterial'nogo) priapizma. Research’n Practical Medicine Journal. 2017;4(4):99-109. https://DOI.org/10.17709/2409-2231-2017-4-4-11
18. S. K. Yarovoi, R. A. Khromov, V. N. Shipovskii. Arterial'nyi priapizm kak oslozhnenie nozhevogo raneniya promezhnosti // Urologiya. 2017. № 5. S. 86–90. DOI: 10.18565/urology.2017.5.86-90.
19. Munshi F, Kwon Y, Gibbens D, Mahmood P, Gazi M, Olweny E. High-flow priapism treated with selective embolization of a helicine branch of the penile artery: A case report and selected review of the literature. Urol Ann. 2020;12(1):103. DOI: 10.4103/UA.UA_45_19
20. Shapiro RH, Berger RE. Post-traumatic priapism treated with selective cavernosal artery ligation. Urology. 1997;49(4):638-643. DOI: 10.1016/S0090-4295(97)00045-9
21. Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R. Priapism: Pathogenesis, Epidemiology, and Management. J Sex Med. 2010;7(1):476-500. DOI: 10.1111/j.1743-6109.2009.01625.x
