Abstract
A disfunção erétil (DE) representa um distúrbio comum de caráter multifatorial. Os autores relatam um caso de paciente vítima de trauma perineal evoluindo com DE por fístula da artéria bulbar para o corpo esponjoso peniano, promovendo um shunt arteriovenoso culminando com déficit de ereção, congestão peniana e dor. O mesmo foi submetido ao tratamento endovascular por embolização com sucesso e encontra-se no sexto mês de acompanhamento ambulatorial, com retorno às suas atividades sexuais e sem queixas de rigidez peniana e dor.
Highlights
Erectile dysfunction (ED) is defined as a persistent failure to initiate and sufficiently maintain an erection for a satisfactory sexual performance
Perineal trauma may be related to erectile dysfunction due to penile fracture sequel, prolonged priapism sequel or
We presented a rare case of posttraumatic bulbospongious fistula, which evolved to erectile dysfunction and painful maintenance of penile tumescence
Summary
Erectile dysfunction (ED) is defined as a persistent failure to initiate and sufficiently maintain an erection for a satisfactory sexual performance. Vasculogenic erectile dysfunction presents itself as one of the main representatives of this scenario, with welldefined risk factors, such as hypertension, dyslipidemia, obesity, smoking and cardiovascular disease[5,6] It may be caused by the obstruction of arterial blood flow due to venous incompetence (varicocele) or obstruction of the venous system (veno-occlusive disease). Penile arteriovenous fistulas have trauma as its main etiology and represent a rare cause of erectile dysfunction. The remainder of physical, urological and vascular examination was normal Among complementary exams, he had a negative urine culture, prostatic ultrasound within the standard of normality, penile Doppler ultrasound showing no detectable changes, and pelvic arteriography showing arteriospongious fistula. Patient had an uneventful postoperative, with significant improvement in penile tumescence and pain, and was discharged after 12 hours of hospitalization, without specific medication. He returned to sexual activities after 30 days postoperatively, without complaints
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