Fig. 1. Post-traumatic priapism. Fig. 3. Hematoma in the right corpora cavernosum.		Fig. 2. Color-flow duplex sonography shows an area of increased velocity in the proximal right cavernosal artery. Fig. 4A. Diagnostic arteriogram shows a cavernosal artery to cavernosal body fistula.
Case Reference No. CC-0298-05 A 28-year-old man working as a welder in a shipyard suffered a straddle-type injury after falling through a hole in the lower decking of a ship. He developed priapism that day and was seen by a primary care physician who did nothing. After 10 days, the patient went back to the primary care physician, who then referred him to a urologist for persistent priapism. The urologist referred him to our interventional service. The patient had priapism on physical examination (Fig. 1). Duplex sonography showed an area of velocity acceleration in the proximal right cavernosal artery (Fig. 2) and an accompanying cavernosal hematoma (Fig. 3). The diagnostic arteriogram showed a cavernosal artery to cavernosal body fistula (Fig. 4A). The penile artery distal to the scrotal artery was selected with a 3-F catheter and embolized with Gelfoam torpedoes. The completion arteriogram showed no continued evidence of the fistula (Fig. 4B). The left side was then studied and also showed a smaller fistula (Fig. 5A). The penile artery was embolized in a fashion similar to the right. The completion arteriogram showed no visualization of the fistula (Fig. 5B). The patient made an uneventful recovery. After 48 hours the priapism became less severe. After 6 months the patient had regained normal erectile and sexual function. Questions 1) Is post-traumatic priapism a urologic emergency? This patient did well with delayed treatment despite being at risk for ischemic necrosis. 2) Is treatment necessary? Refer to: Conservative management of high-flow priapism. Urology 1995; 46(3):419­424.		Fig. 4B. Completion arteriogram after embolization shows no filling of the fistula. Fig. 5A. Diagnostic arteriogram of the left side shows similar findings to those on the right. Fig. 5B. Completion arteriogram shows no filling of the fistula.