Journal Article

Super-selective arterial embolization in the therapy of non-ischemic priapism—a single-center study and literature review

Lerchbaumer, Markus, Collettini, Federico, de Bucourt, Maximilian, Fehrenbach, Uli, Auer, Timo Alexander, Lenk, Julian, Gebauer, Bernhard, Aleixo, Carolina Dominguez, Lindholz, Maximilian

2026

Overview

Background The goal of our analysis is to provide technical information and clinical long-term data on arterial embolization for non-ischemic priapism. Furthermore, this study presents a comprehensive literature review. Methods We analyzed patient data from June 2005 to June 2025 at a large university hospital, focusing on patients with non-ischemic priapism lasting over 1 week, unresponsive to conservative treatment, and referred for arterial embolization. Age, symptom etiology, initial diagnostic modality, embolic agent, uni- or bilateral arterial supply of the fistula/pseudoaneurysm, technical success, clinical outcome, need for a second attempt, erectile dysfunction, adverse events, and mean follow-up time needed were assessed. Findings were contextualized with studies from the past two decades. Results A total of 15 male patients with non-ischemic priapism due to blunt, penetrating trauma or of idiopathic origin, were included in this analysis. The embolic agents chosen included gelatin sponge, polyvinyl alcohol particles, autologous clot, microcoils, and a combination of microcoils with gelatin sponge or polyvinyl alcohol particles. Technical success was achieved in 14 patients (93.3%). A second or third intervention was needed in three cases (20.0%) to achieve clinical success. Documented adverse events included procedure-related findings such as penile skin changes and deviation in two patients (13.3%). No new cases of erectile dysfunction were reported (0%). Conclusion Our findings support super-selective arterial embolization as a safe, technically successful, and minimally invasive therapy option for non-ischemic priapism after conservative measures fail. Moreover, our data suggest that arterial embolization is associated with long-term symptom improvement without significantly impairing sexual function. Graphical Abstract

• Publisher: Springer International Publishing,Springer Nature B.V,Springer,SpringerOpen
• Subject: Angiography / Arterial embolization / Blood gas analysis / Decision making / Embolization / Etiology / Fistula / Genital diseases / Imaging / Intervention / Interventional Radiology / Ischemia / Medical imaging / Medicine / Medicine & Public Health / Original / Original Article / Patients / Penis / Priapism / Pseudoaneurysm / Radiology / Success / Trauma / Ultrasonic imaging