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Penile Trauma and Priapism

  • Michele BertolottoEmail author
  • Massimo Valentino
  • Francesca Currò
  • Mariano Iannelli
  • Gladiola Kaso
  • Libero Barozzi
Chapter

Abstract

Penile traumas can result from penetrating or non-penetrating injuries. Diagnosis of albugineal disruption must be obtained as soon as possible since early surgical repair reduces significantly the rate of posttraumatic curvature and fibrosis. MR imaging is the modality of choice to investigate the integrity of the tunica albuginea. In expert hands, however, ultrasonography can be as informative as MR. It is able to detect the exact site of the tear as an interruption of the thin echogenic line of the tunica albuginea.

Colour Doppler ultrasonography is the imaging modality of choice to evaluate patients with high-flow priapism. Diagnosis of low-flow and stuttering priapism is based on history and clinics. Colour Doppler ultrasonography can show patent cavernosal arteries either with high-velocity, high-resistance flows or low-velocity/absent cavernosal artery flows. Focal or diffuse cavernosal fibrosis can be identified with ultrasound as echogenic areas in the cavernosal bodies or diffuse echogenicity of the corpora cavernosa.

Keywords

Erectile Dysfunction Colour Doppler Ultrasonography Tunica Albuginea Penile Fracture Cavernosal Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video.48.1

Posttraumatic high-flow priapism. Duplex Doppler interrogation of the cavernosal artery tear shows high-velocity, turbulent flows. (MP4 3184 kb)

References

  1. 1.
    Bertolotto M, Calderan L, Cova MA (2005) Imaging of penile traumas – therapeutic implications. Eur Radiol 15(12):2475–2482. doi: 10.1007/s00330-005-2900-0 CrossRefPubMedGoogle Scholar
  2. 2.
    Bertolotto M, Ciampalini S, Martingano P, Mucelli FP (2009) High-flow priapism complicating ischemic priapism following iatrogenic laceration of the dorsal artery during a winter procedure. J Clin Ultrasound JCU 37(1):61–64. doi: 10.1002/jcu.20479 CrossRefPubMedGoogle Scholar
  3. 3.
    Liguori G, Garaffa G, Trombetta C, Capone M, Bertolotto M, Pozzi-Mucelli F, Belgrano E (2005) High-flow priapism (HFP) secondary to Nesbit operation: management by percutaneous embolization and colour Doppler-guided compression. Int J Impot Res 17(3):304–306. doi: 10.1038/sj.ijir.3901251 CrossRefPubMedGoogle Scholar
  4. 4.
    Pavan N, Tezzot G, Liguori G, Napoli R, Umari P, Rizzo M, Chiriaco G, Chiapparrone G, Vedovo F, Bertolotto M, Trombetta C (2014) Penile fracture: retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome. Archivio Italiano Di Urologia, Andrologia Organo Ufficiale [Di] Societa Italiana Di Ecografia Urologica e Nefrologica/Associazione Ricerche In Urologia 86(4):359–370. doi: 10.4081/aiua.2014.4.359 CrossRefGoogle Scholar
  5. 5.
    Pretorius ES, Siegelman ES, Ramchandani P, Banner MP (2001) MR imaging of the penis. Radiographics: a review publication of the Radiological Society of North America, Inc 21 Spec No:S283–298; discussion S298–289. doi: 10.1148/radiographics.21.suppl_1.g01oc24s283
  6. 6.
    Choi MH, Kim B, Ryu JA, Lee SW, Lee KS (2000) MR imaging of acute penile fracture. Radiographics Rev Publ Radiol Soc N Am Inc 20(5):1397–1405. doi: 10.1148/radiographics.20.5.g00se051397 Google Scholar
  7. 7.
    Avery LL, Scheinfeld MH (2013) Imaging of penile and scrotal emergencies. Radiographics Rev Publ Radiol Soc N Am Inc 33(3):721–740. doi: 10.1148/rg.333125158 Google Scholar
  8. 8.
    Bertolotto M, Mucelli RP (2004) Nonpenetrating penile traumas: sonographic and Doppler features. AJR Am J Roentgenol 183(4):1085–1089. doi: 10.2214/ajr.183.4.1831085 CrossRefPubMedGoogle Scholar
  9. 9.
    Brant WO, Bella AJ, Garcia MM, Tantiwongse K, Dean RC, Lue TF (2007) Isolated septal fibrosis or hematoma – atypical Peyronie’s disease? J Urol 177(1):179–182. doi: 10.1016/j.juro.2006.08.065; discussion 183CrossRefPubMedGoogle Scholar
  10. 10.
    Bertolotto M, Quaia E, Mucelli FP, Ciampalini S, Forgacs B, Gattuccio I (2003) Color Doppler imaging of posttraumatic priapism before and after selective embolization. Radiographics Rev Publ Radiol Soc N Am Inc 23(2):495–503. doi: 10.1148/rg.232025077 Google Scholar
  11. 11.
    Bertolotto M, Zappetti R, Pizzolato R, Liguori G (2008) Color Doppler appearance of penile cavernosal-spongiosal communications in patients with high-flow priapism. Acta Radiol 49(6):710–714. doi: 10.1080/02841850802027026 CrossRefPubMedGoogle Scholar
  12. 12.
    Ciampalini S, Savoca G, Buttazzi L, Gattuccio I, Mucelli FP, Bertolotto M, De Stefani S, Belgrano E (2002) High-flow priapism: treatment and long-term follow-up. Urology 59(1):110–113CrossRefPubMedGoogle Scholar
  13. 13.
    Savoca G, Pietropaolo F, Scieri F, Bertolotto M, Mucelli FP, Belgrano E (2004) Sexual function after highly selective embolization of cavernous artery in patients with high flow priapism: long-term followup. J Urol 172(2):644–647. doi: 10.1097/01.ju.0000132494.44596.33 CrossRefPubMedGoogle Scholar
  14. 14.
    Bertolotto M, Pavlica P, Serafini G, Quaia E, Zappetti R (2009) Painful penile induration: imaging findings and management. Radiographics Rev Publ Radiol Soc N Am Inc 29(2):477–493. doi: 10.1148/rg.292085117 Google Scholar
  15. 15.
    Bertolotto M, Serafini G, Savoca G, Liguori G, Calderan L, Gasparini C, Mucelli RP (2005) Color Doppler US of the postoperative penis: anatomy and surgical complications. Radiographics Rev Publ Radiol Soc N Am Inc 25(3):731–748. doi: 10.1148/rg.253045100 Google Scholar
  16. 16.
    Bertolotto M, Serafini G, Dogliotti L, Gandolfo N, Gandolfo NG, Belgrano M, Prefumo F (2005) Primary and secondary malignancies of the penis: ultrasound features. Abdom Imaging 30(1):108–112CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Michele Bertolotto
    • 1
    Email author
  • Massimo Valentino
    • 2
  • Francesca Currò
    • 1
  • Mariano Iannelli
    • 1
  • Gladiola Kaso
    • 1
  • Libero Barozzi
    • 3
  1. 1.Department RadiologyUniversity of Trieste, Ospedale di CattinaraTriesteItaly
  2. 2.S.O.C. Radiologia ASS 3 FVG, Ospedale Sant’Antonio AbateTolmezzoItaly
  3. 3.Radiology UnitCasa di Cura Madre Fortunata TonioloBolognaItaly

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