A Rare Entity in Children: Two Cases of Post-traumatic Priapism With Spontaneous Resolution.

Abstract

This report presents two pediatric cases of post-traumatic high-flow priapism managed using a conservative approach. The first case involved a six-year-old boy who developed a persistent, painful penile erection three days after sustaining perineal trauma from a seesaw incident. Color Doppler ultrasonography revealed an arteriovenous fistula with a localized hematoma. The second case involved a five-year-old boy who presented with a persistent, painless erection following a bicycle-related groin injury; Doppler ultrasonography confirmed a high-flow arteriocavernosal fistula. Both patients were managed with intermittent penile shaft compression administered in two‑hour cycles (compression followed by release, with immediate decompression upon discomfort). Follow-up duplex ultrasonography at two weeks confirmed the resolution of the fistula, and both patients remained asymptomatic for at least three months. These cases illustrate that a conservative management strategy can serve as an effective alternative to invasive interventions in pediatric post-traumatic high-flow priapism.