Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a persistent, semi-rigid, painless penile erection following recent perineal or penile trauma. Onset was [Time/Days] post-injury. Denies significant penile pain or systemic symptoms. No history of sickle cell disease, hematologic disorders, or intracavernosal injection therapy.
Clinical Examination Findings
Physical examination reveals a semi-rigid, non-tender penile shaft. Penile skin is warm and normal in color. No signs of ischemia or necrosis. Perineal examination may reveal a pulsatile mass or hematoma. Doppler ultrasound confirms high-velocity, high-flow arterial blood supply within the corpora cavernosa, consistent with arterial-lacunar fistula.
Treatment Protocol
Initial management involves conservative observation for spontaneous resolution. If persistent, selective arterial embolization (autologous clot, gel foam, or microcoils) is indicated under fluoroscopic guidance. Surgical ligation of the fistula is reserved for refractory cases.