To investigate the prevalence and Doppler characteristics of penile cavernosal-spongiosal communications (CSC) in patients with postraumatic priapism. These vessels are either anastomoses connecting the cavernosal arteries with the urethral arterial network or afferent vessels to the corpus spongiosum. In normal subjects and in impotent patients CSC typically display flows directed towards the corpus spongiosum.

Nine consecutive patients with post-traumatic priapism underwent penile color Doppler US. The prevalence and spectral characteristics of CSC were evaluated before and after angiographic embolization.

Before angiographic embolization three/9 patients had CSC with retrograde flow supplying the arterial-cavernosal fistula (ACF). In one case the CSC originated from the portion of the torn cavernosal artery proximal to the ACF, in 2 cases it originated from the distal portion of the torn vessel which supplied the ACF with retrograde flow.
After angiographic embolization CSC with retrograde flow were visible in 4/7 patients in whom the ACF was not completely closed. No CSC were detected in 2 patients in whom the ACF closed completely.

Doppler interrogation of CSC can be useful in patients with high flow priapism, since these vessels can represent collateral vessels feeding the ACF.