Recurrent idiopathic high-flow priapism treated with selective arterial embolization after repeated initial treatments for low-flow priapism.

High-flow priapism is most often seen following perineal andpenile trauma. We report the case of a 32-year-old man whopresented with recurrent idiopathic priapism initially treated aslow-flow priapism on 8 previous emergency department visits.Pelvic angiography revealed an abnormal communication betweenthe left cavernosal artery and the left corpus cavernosum andled to the diagnosis of high-flow priapism. Treatment involvedembolization of the left common penile artery, which resultedin successful resolution of the recurrent priapism. Our patient’scase highlights the importance of an appropriate work-up, includingimaging, to distinguish high- and low-flow priapism and toprovide appropriate care. Le priapisme a haut debit est le plus souvent observe apres untraumatisme perineal et penien. Nous decrivons le cas d’un hommede 32 ans atteint de priapisme idiopathique recurrent traite audepart comme un priapisme a bas debit lors de 8 visites anterieuresau service des urgences. Une angiographie pelvienne a reveleun passage anormal entre l’artere caverneuse gauche et le corpscaverneux gauche et a mene au diagnostic de priapisme a hautdebit. Un traitement par embolisation de l’artere penienne gauchea ete realise, entrainant la disparition complete du priapisme recurrent.Ce cas illustre l’importance d’une analyse approfondie, notammenta l’aide d’epreuves d’imagerie, afin de distinguer les cas ahaut debit des cas a bas debit et de choisir les soins appropries.