Yunus Emre ÇAKMAKLI, İshak YILDIZHAN, Banu ALICIOĞLU

Posttravmatik Erektil Disfonksiyon Olgusu: Korpus Kavernozum Psödoanevrizması

Amaç: Erektil disfonksiyon prevalansı yaşla birlikte artan patofizyolojisinde çeşitli nedenleri barındıran yaygın bir sağlık sorunudur. Travmatik nedenli erektil disfonksiyonun olası mekanizması bir vaka aracılığıyla gözden geçirilecektir. Olgu: Yirmialtı yaşında erkek hasta on gün önce ağaçtan düşme sonrası gelişen erektil disfonksiyon nedeniyle üroloji polikliniğinden tarafımıza Renkli Doppler Ultrasonografi incelemesi istemiyle gönderildi. Sağ korpus kavernozumda psödoanevrizma ve ilişkili arteriovenöz fistül izlendi. Sonuç: Künt travma öyküsü olan hastalarda erektil disfonksiyon varlığında vasküler nedenler akılda tutulmalı ve buna yönelik görüntülemelerden faydalanılmalıdır.

A Case of Posttraumatic Erectile Dysfunction: Pseudoaneurysm of Corpus Cavernosum

Aim: Erectile dysfunction is a common health problem with increasing prevalance during aging secondary to diverse underlying pathophysiologic causes. A traumatic erectile dysfunction case is presented. Case: A twenty-six-year-old male presented with erectile dysfunction after falling from a tree referred to our department by Urology clinic for Color Doppler Ultrasound examination. A pseudoaneurysm and an associated arteriovenous fistula in the right corpus cavernosum is detected. Conclusion: In case of a patient suffering from erectile dysfunction with blunt trauma history, vascular causes have to be suspected and related imaging studies should be utilized.

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1. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med 2007;120(2):151-157.
2. Grover SA, Lowensteyn I, Kaouache M, Marchand S, Coupal L, DeCarolis E, Zoccoli J, Defoy I. The prevalence of erectile dysfunction in the primary care setting: Importance of risk factors for diabetes and vascular disease. Arch Intern Med 2006;166(2):213-219.
3. Donatucci CF, Lue TF. Erectile dysfunction in men under 40: Etiology and treatment choice. Int J Impot Res 1993;5:97-103.
4. Augusto F, Oliveira C, Sousa C, Campedelli FL, Walter H, Filho F, Barreto J, Lauar F, Meirelles S, Barreto M, Silva PM. Endovascular treatment of erectile dysfunction by traumatic arteriospongious fistula: Case report. J Vasc Bras 2012;11(4):317-319.
5. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am 2005;32(4):379-395.
6. Lue TF, Hricak H, Schmidt RA, Tanagho EA. Functional evaluation of penile veins by cavernosgraphy in papaverine- induced erection. J Urol 1986;135:479-482.
7. Vickers MA Jr, Benson CB, Richie JP. High resolution ultra- sonography and pulsed wave Doppler for detection of corporo- venous incompetence in erectile dysfunction. J Urol 1990;143:1125-1127.
8. Türkay R, Yenice MG, Aksoy S, Şeker G, Şahin S, İnci E, Tuğcu V, Taşcı Aİ. Contribution of MRI to clinically equivocal penile fracture cases. Ulus Travma Acil Cerrahi Derg 2016;22(6):549 552.
9. Koga S, Saito Y, Arakaki Y, Nakamura N, Matsuoka M, Saita H, Yoshikawa M, Ohyama C. Sonography in fracture of the penis. Br J Urol 1993;72:228-229.
10. Yesilkaya Y, Peynircioglu B, Gulek B, Topcuoglu M, Inci K. Autologous blood-clot embolisation of cavernosal artery pseudoaneurysm causing delayed high-flow priapism. Pol J Radiol 2013;78(2):54 56.
11. Berger R, Billups K, Brock G, Broderick GA, Dhabuwala CB, Goldstein I, Hakim LS, Hellstrom W, Honig S, Levine LA, Lue T, Munarriz R, Montague DK, Mulcahy JJ, Nehra A, Rogers ZR, Rosen R, Seftel AD, Shabsigh R, Steers W; AFUD Thought Leader Panel on Evaluation and Treatment of Priapism. Report of the American Foundation for Urologic Disease (AFUD) Thought Leader Panel for evaluation and treatment of priapism. Int J Impot Res 2001;13 Suppl 5:S39 S43.
12. Ridgley J, Raison N, Sheikh MI, Dasgupta P, Khan MS, Ahmed K. Ischaemic priapism: A clinical review. Turk J Urol 2017;43(1):1 8.
13. Keck B, Lotter G, Wieland WF, Wullich B, Uder M, Engehausen DG, Fritsche HM. Sonographic diagnosis of a posttraumatic arteriocavernosal fistula resulting in high-flow priapism. J Clin Ultrasound 2012;40(1):60-62.
14. Kim KR. Embolization treatment of high-flow priapism. Semin Intervent Radiol 2016;33(3):177-181.
15. Volgger H, Pfefferkorn S, Hobisch A. Posttraumatic high- flow priapism in children: noninvasive treatment by color Doppler ultrasound-guided perineal compression. Urology 2007;70(3):590.e3-5.
16. Celtikci P, Ergun O, Tatar IG, Conkbayir I, Hekimoglu B. Superselective arterial embolization of pseudoaneurysm and arteriovenous fistula caused by transurethral resection of the prostate. Pol J Radiol 2014;79:352-355.