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+A 35-year-old man, with a history of lupus, unaffiliated hepatitis and circumcision at the age of 4 years, consulted for bifidity of the urinary stream. On examination, the meatus was normal and there were no fistulas. The penis was larger than normal and the corpora cavernosa were erect, with no involvement of the glans penis.
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+On cross-examination, he states that he has been in this situation for as long as he can remember and that, as a child, he used to hold his penis with a string around his waist so that his erection would not be noticed. Regarding his sexual activity, he affirms his homosexual choice and his satisfaction with the size of his penis and his permanent erection, which allows him to have successive and indefinite coitus. He has no ejaculation problems.
+Penile Doppler ultrasound was performed, with time/velocity values in the corpora cavernosa compatible with erection (right cavernous systolic velocity of 51 cm/sec and 41 cm/sec on the left side). Probable arterio-cavernous fistula in the proximal portion of the right corpus cavernosum.
+MRI angiography demonstrates arterio-cavernous fistula on the right side, which is present in both the arterial and venous phases and confirms the diagnosis of high-flow arterial priapism.
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