Unilateral embolization of an arterio-cavernous fistula in the treatment of post-traumatic non-ischemic-priapism: permanent coiling after immediate temporary agent failure

A healthy 24-year-old male patient presented with a history of straddle-trauma from a bicycle accident and concomitant non-ischemic-priapism lasting for ten days. On a contrast-enhanced computed tomography scan an arterio-cavernous fistula establishing a connection between the right cavernosal artery and the ipsilateral corpus cavernosum was diagnosed. Super-selective unilateral arterial embolization was performed using gelatin sponge and microcoils. Technical success became evident with the consecutive detumescence of the penis and long-term preservation of baseline urogenital functions.