Multimodality magnetic resonance imaging for the diagnosis of high-flow priapism following a straddle injury: A case report

RATIONALE: Priapism is a common urologic emergency, but high-flow penile priapism (HFP) caused by trauma is very rare. Therefore, HFP diagnosis and treatment are still not standardized. PATIENT CONCERNS: A 29-year-old man was admitted to the urology department of our hospital on August 01, 2019, due to “persistent penile erection caused by a straddle injury.” DIAGNOSIS: On July 17, 2019, the patient underwent Doppler ultrasonography, which indicated swollen corpus cavernosum. INTERVENTIONS: The patient took over-the-counter anti-inflammatory drugs but the erectile state of the penis remained unchanged. A second perineal injury resulted in hospital admission. Multimodality magnetic resonance imaging (MRI) scan showed nodular abnormal signals at the right corpus cavernosum root. Subsequently, selective arterial interventional angiography confirmed the MRI findings. Spring coils were then inserted for embolization, and the pseudoaneurysm, fistula, and priapism disappeared. OUTCOMES: Two months after surgery, sexual stimuli could normally cause penile erection, with normal hardness. The patient's sexual life returned to normal 3 months after surgery. CONCLUSION: Multimodality MRI is very effective in detecting high blood flow priapism. Its application would improve the clinical management of this ailment.