Purpose: To present three cases of arterial high flow priapism (HFP) and propose a management algorithm for this condition.
Materials and methods: We studied three children with post-traumatic arterial HFP (two patients with perineal trauma and one with penis trauma).
Results: Spontaneous resolution was observed in all the patients. The time of resolution by a return to a completely flaccid penis was different: 14, 27 and 36 days in each case.
Conclusions: Absence of long-term damaging effects of arterial HFP on erectile tissue combined with the possibility of spontaneous resolution associated with blunt perineal trauma are suggestive signs for the introduction of an observation period in the management algorithm of HFP. Such a period may help to avoid unnecessary surgical intervention. Thus, these cases reinforce the decision to manage these patients conservatively and avoid angiographic embolization as a first therapeutic choice.