Selective Penile Arterial Embolization Does Not Affect Long-Term Erectile Function in Patients with Non-Ischemic Priapism: An 18-Year Experience

Non-ischemic priapism occurs when there is a bypass of arteriolar vasoconstrictive tone leading to unrestrained cavernosal inflow. This generally occurs following traumatic injury or cavernosal shunt procedure. The American Urological Association recommends penile artery arteriography followed by selective embolization as the standard therapy for the treatment of non-ischemic priapism once a trial of observation has been completed.

While there are limited reports describing the success of this technique, there is even more scant data related to the long-term effect of embolization on erectile function. This study reinforced that selective penile artery embolization is a highly successful treatment modality with immediate resolution of symptoms in 90% (18/20) of patients, but more importantly discovered that erectile function following embolization was preserved. The mean Sexual Health Inventory for Men score, a screening survey to assess erectile function, following embolization was 22.1, consistent with no erectile dysfunction.

The results of the International Index of Erectile Function assessment demonstrated no erectile dysfunction, mild orgasmic dysfunction, mild sexual desire dysfunction, mild intercourse dissatisfaction, and a mild overall dissatisfaction dysfunction. These represent important validated outcome measures which should be incorporated into practices performing endovascular embolization for non-ischemic priapism.

Written by: Jacob J. Bundy, MD, MPH², Jeffrey Forris Beecham Chick, MD, MPH¹, Joseph J. Gemmete, MD, FSIR², Rajiv N. Srinivasa, MD², Casey Dauw, MD³, Ravi N. Srinivasa, MD²

1. Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, Ann Arbor, MI; Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, Alexandria, VA
2. Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, Ann Arbor, MI
3. Department of Urology, University of Michigan Health Systems, Ann Arbor, MI

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