Superselective embolization in posttraumatic priapism with Glubran 2 acrylic glue

two patients with posttraumatic priapism underwent transcatheter embolization using microcoils, resulting in temporary penile detumescence and an apparent resolution of the artero-venous fistula. In both cases, priapism recurred 24 hours after the procedure and was successfully treated through selective transcatheter embolization of the nidus using acrylic glue (glubran 2). the patients showed complete recovery of sexual activity within 30 days from the procedure and persistent exclusion of the artero-venous fistula after a 12-month follow-up. key words: priapism—posttraumatic—fistula—embolization— glubran 2—coils priapism is defined as a prolonged penile erection not related to sexual arousal, often causing pain [1]. there are two types of priapism: the more frequent low-flow priapism associated with a veno-occlusive pathogenesis and the less frequent high-flow posttraumatic priapism. low-flow priapism is a medical emergency due to ischemic damage of the corpora cavernosa causing fibrosis and impotence [2]. High-flow priapism is the consequence of direct perineal or penile trauma with laceration of a cavernosal artery, causing direct blood flow into the cavernosal sinusoids with exclusion of the high- resistance helicine arterioles [1]. the late onset of posttraumatic priapism is due to the early formation of a blood clot at the site of the arterial lesion. subsequent nocturnal penile tumescences and the action of physiological anticoagulant agents cause mobilization of the clot itself establishing the artero-venous fistula (AVF) and resulting in the prolonged penile erection. we present two patients with posttraumatic priapism who underwent embolization with microcoils, with recurrence of the AVF after 24 h, and were definitely treated with superselective embolization using acrylic glue (Glubran 2).