超選択的動脈塞栓術で治癒した外傷性持続勃起症

Traumatic high flow priapism recovered by superselective embolization

　症例は20歳，男性。会陰部打撲後2日目より陰茎の持続勃起を自覚していたが，受傷後18日目に当科を受診した。陰茎海綿体血液ガス分析，およびドプラエコーにて流入過剰型持続勃起症と診断した。受傷後21日目，陰茎動脈造影にて，左内陰部動脈末梢に血管外漏出を認め，これによる流入過剰型持続勃起症と診断し，スポンゼルを用いて超選択的動脈塞栓術を施行した。術後，再発および合併症を認めず，通常の勃起・射精が可能である。

Persisting erection without sexual stimulus appeared from the 2nd day after perineal trauma was diagnosed priapism in a 20-year-old man. At the time of the first medical examination in our hospital,the penis was erected,without any pain or urination trouble. High flow priapism was suspected by intracavernous blood gas study and color doppler ultrasound study. The internal pudendal arteriography was performed on the 21st after perineal trauma,and superselective embolization of left internal pudendal arteries using gelatine sponges was done. After the operation,priapism disappeared with no recurrence and normal erection and ejaculation by sexual stimulus are restored.