spontaneous resolution of delayed onset, posttraumatic high-flow priapism

Priapism is an uncommon but serious condition with major long-term sequelae. The commoner, ischemicvariety is a medical emergency requiring immediate intervention in order to avoid erectile dysfunction. However,the high flow variety is non-ischemic and the patient may not seek immediate therapy. The options ofmanagement for this rare, painless form of priapism vary from conservative therapy to embolization of theinternal pudendal artery or, in some cases, surgery that may result in subsequent erectile dysfunction. Wepresent a case of a 24-year-old man who presented with priapism of six-day duration, 10 days after perinealinjury. Doppler ultrasonogram of the penis revealed a cavernosal artery pseudoaneurysm. Pudendal arteryangiogram done four days later revealed no leak and the priapism subsided spontaneously with subsequentreturn of normal erections.