759 - Critical Flows: Interventional Radiology in the Management of Acute Penile Emergencies

Monday, April 13, 2026

5:39 PM - 5:45 PM ET

Abstract Presenter(s)

AW

Ashley Woodford, MD

Radiology Resident
Temple University Hospital, United States

Author/Co-author(s)

KK

Krishna Kinariwala, MD

Interventional Radiology Resident
Temple University Hospital, United States
IL

Ian Leopold, MD

Assistant Professor of Clinical Radiology
Temple University Hospital, United States
SL

Shane Lee, MD

Associate Professor of Clinical Radiology
Temple University Hospital, United States
JP

Joseph Panaro, MD

Clinical Professor of Vascular and Interventional Radiology
Temple University Hospital, United States
PG

Perry Gerard, MD, FACR, MBA

Professor of Clinical Radiology
Westchester Medical Center, United States
JM

Jared Meshekow, MD, MPH

Clinical Associate Professor, Vascular and Interventional Radiology
Temple University Hospital, United States

Learning Objectives:

Provide an overview of the types of acute penile emergencies that may require interventional radiology (IR).

Review the angiographic findings and technical approach to penile arterial and venous interventions.

Discuss outcomes, complications, and clinical considerations for optimizing patient care.

Background: While acute penile emergencies are uncommon, they represent time-sensitive conditions that can result in significant morbidity if not rapidly diagnosed and treated. There are several etiologies that may necessitate IR intervention. These include high-flow parapiasm, penile trauma with arterial injury, pseudoaneurysm formation, venous thrombosis, and postoperative complications after penile prostheses insertion. Interventional radiology provides a minimally invasive, organ-preserving alternative to surgery through targeted embolization, thrombolysis, and venoplasty techniques. Timely recognition and multidisciplinary collaboration between urology, trauma surgery, and IR are essential to preserve function and prevent long-term complications such as erectile dysfunction or penile necrosis.

Clinical Findings/Procedure Details: Common indications for IR include:

High-Flow Priapism: Characterized prolonged erection often post-trauma. Diagnosis is based on Doppler US and angiography, with arteriocavernosal fistulas. Superselective microcatheterization and embolization with autologous clot, coils, or particulate agents minimze erectile dysfunction risk.

Penile Arterial Trauma: Penile fracture, pelvic fracture, or penetrating trauma may result in extravasation or pseudoaneurysm. Embolization can be performed emergently to control bleeding.

Postoperative Hemorrhage: After penile prosthesis placement or other urological surgery, targeted embolization may salvage the device and prevent hematoma expansion.

Venous Thrombosis: In select cases of dorsal or cavernosal penile vein thrombosis, catheter-directed thrombolysis or thrombectomy may be indicated, if pain is present or the risk of progression is high.

Interventions emphasize preserving cavernosal artery patency and non-target embolization.

Conclusion and/or Teaching Points: Interventional radiology can play a pivotal role in the evaluation and management of acute penile emergencies, offering organ-sparing therapy and rapid hemostasis. Advances in microcatheter techniques and embolic materials have improved precision and safety and may improve outcomes. An early consultation with IR may help minimize the need for open surgical exploration, minimize complications, and optimize functional outcomes.