CASE REPORT   

Journal of Radiological Review 2021 December;8(4):340-3

DOI: 10.23736/S2723-9284.21.00145-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Post-traumatic prepubertal priapism: a rare occurrence

Annamaria G. NUCERA ¹ ✉, Nicola ARCADI ¹, Anna FERRARELLI ¹, Domenico MINASI ², Teodolinda R. GIORDANO ², Elda PITROLO ²

¹ Unit of Radiology, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy; ² Unit of Pediatrics, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy

Priapism is a prolonged penile erection (>4 hours), beyond or unrelated to sexual activity. Current data indicate an incidence around 0.5-0.9 per 100,000 male person-years. It is divided into two main forms: ischemic (low-flow or veno-occlusive) priapism and non-ischemic (high-flow or arterial) priapism. A special form of recurrent and self-limited episodes of ischemic priapism is known as stuttering priapism. The most common form with nearly 95% is ischemic priapism; the other 5% is mainly represented by non-ischemic priapism. Priapism results from altered penile hemodynamics: decrease of venous outflow in the ischemic form or increase of arterial inflow in the non-ischemic form. In the first, there is a risk of tissue ischemia; for this reason, it is a urological emergency with a risk of complications that progressively increases over time. In the second, the prognosis is typically more favorable even in the case of delayed treatment as tissue oxygenation is usually preserved; however, cavernosal smooth-muscle damage and fibrosis are possible. The case of an episode of post-traumatic priapism in an 11-year-old boy is reported here. Ultrasonography (US) of the penis showed changes in the echotexture of the corpora cavernosa due to tissue edema (B-mode) and no flow in the carvernosal arteries (color-Doppler). The ultrasound diagnosis of ischemic priapism was intraoperatively confirmed with unsuccessful aspiration of oxygenated blood from the corpora cavernosa followed by irrigation and corpora-glanular shunt.

KEY WORDS: Priapism; Wounds and injuries; Ultrasonography