Posttraumatic pseudoaneurysm of the pudendal artery successfully managed with embolization

Delayed Refractory Urethrorrhagia Secondary to Traumatic Pseudoaneurysm of Bulbourethral Artery Managed by Superselective Coil Embolization

Background: Delayed persistent urethral hemorrhage caused by pseudoaneurysm of bulbourethral artery after straddle injury is a rare event. In this case report, we underline the cause, diagnostic methods, and image-guided treatment modality of straddle injury-induced symptomatic pseudoaneurysm of bulbourethral artery. Case Presentation: A 44-year-old Indian man, with history of straddle injury, was managed conservatively with per urethral Foley catheter placement. He had an uneventful initial period. One week after the injury, he complained of recurrent episodes of gross urethrorrhagia, which failed to resolve with conservative management. On further evaluation, he was found to have a pseudoaneurysm of bulbourethral artery, which was effectively managed by superselective intra-arterial coiling. Prompt diagnosis and timely management by superselective coiling helped in achieving desirable outcome without any undue complication of the injury and procedure. Conclusion: We report the largest pseudoaneurysm poststraddle injury reported till date. Considering its rarity, the desired diagnostic and treatment protocol has been highlighted. Using novel superselective angioembolization technique, adequate and permanent relief from symptoms and complications was achieved.

Traumatic Penile Pseudoaneurysm After Straddle Injury Presenting With Life Threatening Anemia: A Unique Case and a Diagnostic Challenge

Partial urethral disruption after blunt perineal trauma can be initially managed with urethral catheterization. Lower urinary tract symptoms after catheter removal should raise suspicion for urethral stricture and requires further investigation. Lesser known complications require high index of suspicion to prevent life threatening sequelae. In this report, we describe a case of blunt perineal trauma and partial urethral disruption in a pediatric patient presenting with refractory anemia due to a penile artery pseudoaneurysm. We discuss an unusual presentation, challenging diagnosis and management of this rare condition.

Traumatic pseudoaneurysm of bulbourethral artery managed by coil embolization

Urethral injury is a common form of urogenital trauma in males. Urethral injuries can be diagnosed with ease in emergency due to the presence of blood clot at external urethral meatus or inability to catheterize the urethra. Stricture formation is usual sequelae of such injuries. Uncontrolled urethral hemorrhage is a relatively rare complication which can present either as immediate or delayed. Such injuries can be managed conservatively in majority; however, if uncontrolled may require interventional management. Such patients usually have underlying pseudoaneurysm formation or arteriovenous fistula. Here, we are reporting a case of bulbar urethral injury which presented with delayed uncontrolled urethral hemorrhage. On angiography, pseudoaneurysm arising from left bulbourethral artery with active urethral extravasation was noted and was managed with coil embolization.

Transcatheter Embolization of Internal Pudendal Artery Pseudoaneurysm Following Traumatic Urethral Catheterization

Urethral catheterization is a routine procedure. We report an unusual complication due to a traumatic urethral catheterization. The resulting pseudoaneurysm of the bulbar artery required selective embolization of the internal pudendal artery.