Priapism (CME) – online course

Description

Authors: T. Bilhim and N.V. Costa

Reviewers: V. Bérczi, M. Das, G. Eldem, R. Loffroy and C. Nice

This course corresponds to chapter 2.2.1.2.1 Priapism in the European Curriculum and Syllabus for IR.

Abstract

High flow (arterial or non-ischaemic) priapism is a rare entity that is responsible for less than 5% of all priapism situations and is usually related to perineal trauma. Low flow (venous/veno-occlusive or ischaemic) priapism is the most frequent form of priapism and is usually managed by the urology team in an emergency setting with blood aspiration from the corpora cavernosa. Differentiation of high flow (arterial or non-ischaemic) priapism from low flow (venous/veno-occlusive or ischaemic) priapism is fundamental as selective arterial embolisation is only indicated for high flow (arterial or non-ischaemic) priapism. Clinical and laboratory evaluation should be complemented with colour duplex ultrasonography, which is also used for post-embolisation follow-up. High flow (arterial or non-ischaemic) priapism is not a medical emergency, and conservative management can resolve up to 62% of situations. Selective arterial embolisation should be indicated for high flow (arterial or non-ischaemic) priapism after failure of conservative measures within two to three weeks. Interventional radiologists should be familiar with the imaging, catheters and embolisation tools required for this specific and rare clinical scenario. Potential pitfalls include the physiologic bulbar blush that may mimic the arterial-cavernosal fistula responsible for the high flow (arterial or non-ischaemic) priapism. Embolisation of high flow (arterial or non-ischaemic) priapism is very safe, with more than 90% of technical and clinical success rates and preserving potency in over 80% of treated patients.

Learning objectives

• List the mechanisms of both high (arterial or non-ischaemic) and low flow (venous or ischaemic) priapism
• Describe the clinical and radiological evaluation of priapism
• Categorise the surgical and radiological treatments for high flow priapism and their relative merits and discuss these with patients
• List the embolic agents for endovascular treatment (temporary embolisation material: autologous clots, gelatinous foam and permanent embolisation material: coils or N-butyl-cyanoacrylate)
• Describe the expected clinical outcome and the short-term and long-term morbidity
• Describe the technical steps needed for internal pudendal and cavernosal artery cannulation and embolisation by being able to choose and discuss the correct equipment and how to minimise and deal with complications

Further information

This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.1.2.1 Priapism.

The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on May 31, 2025. A non-CME accredited version of the course will remain available for two more years.

The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: May 2023