A 35-year-old male with a history of loos, unrelated hepatitis and circumcision at 4 years of age, who consulted due to bifidity of the voiding jet.
On examination, the meatus was normal and there were no fistulas.
Attention is paid to a penis larger than that which could be considered normal and erection of the vesicular bodies, without involvement of the glans.
1.
Reinterruptedly, he affirms that he has been in this situation since he remembers, and that, as a boy, he held the penis with a string to his waist so that his erection could not be noticed.
About his sexual activity, he affirms his homosexual option and his satisfaction for the size of his penis and his permanent erection, which allows him successive and undefined intercourses.
There is no ejaculation problem.
Doppler ultrasound of the penis was performed, with values of time/velocity in the corpus tendosus compatible with erection (left systolic velocity 41 cm/sec).
Arteriovenous leakage is likely to occur in the proximal portion of the right coronary artery.
NMR angiography shows arteriovenous fistulae on the right side, present both in the arterial and venous phases, confirming the diagnosis of high-flow arterial priapism.
