A 47-year-old male patient, with no toxic habits or pathological history of interest, came to the andrology clinic for prolonged, non-painful erections of approximately 4 years' duration after blunt perineal trauma with the handlebars of a bicycle.
Physical examination revealed enlarged corpora cavernosa, not painful on palpation, with no palpable abnormal pulses. Penile sensitivity was preserved. Mobile testicles in both scrotal pouches without alterations.
As complementary explorations, penile Doppler ultrasound was performed: right cavernous vascularisation apparently preserved; in the most proximal portion of the left corpus cavernosum an anechoic formation was observed (2x1.8x1.5cm) with turbulent flow in its interior, compatible with a long-standing arteriovenous fistula (AVF).

With the diagnosis of high flow Priapism, it was decided to perform pudendal arteriography under local anaesthesia confirming AVF and subsequent embolisation of the same by means of 2 coil 3x5.

After embolisation the patient evolves favourably with complete penile detumecence and normal erections. He is currently asymptomatic.