This retrospective cohort study aims to evaluate the long-term outcomes of superselective transcatheter arterial embolization in patients with high-flow priapism. All patients treated with arterial embolization at our center between 2002 and 2017 for high-flow priapism were included. Demographic and clinical data were collected and analyzed. In July 2022, patients were reassessed using specific questions about their satisfaction with the treatment. Erectile function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Erection Hardness Score (EHS). Thirteen men, with a median age of 30 years (IQR: 24-37), were included in the study. Superselective arterial embolization using permanent occlusive agents was performed in all cases. The blood flow in the fistula was interrupted leading to complete penile detumescence in all patients. At a median follow-up of 175 months (IQR: 74-197), the median IIEF-5 score was 24 (IQR: 21-25) and the median EHS was 4 (IQR: 3-4), indicating preserved erectile function. Additionally, 92.3% of patients expressed satisfaction with the treatment. Superselective transcatheter arterial embolization with non-absorbable agents demonstrates effectiveness and durability as a treatment for high-flow priapism, with preserved erectile function observed over a follow-up period exceeding 10 years. Nonetheless, the interpretation of these findings is limited by the study's small sample size and retrospective design.
