Priapism is of two types. A low-flow (ischemic), painful priapism and the other high-flow (non-ischemic), painless priapism. Penile angiography is not indicated in the painful, low-flow priapism. It is indicated for the high-flow, non-ischemic priapism which is painless. PriapismPriapism is defined as prolonged erection in the absence of a sexual stimulus. It can be classified into 2 types:A. Low-flow (ischaemic) priapism.features little or absent intracorporal blood flow due to veno-occlusion it represents a true compartment syndrome involving the penis manifests as painful, rigid erection cavernous blood gas values are consistent with hypoxia, hypercapnia, and acidosis ischaemic priapism beyond 4th hour requires emergency intervention (decompression of the corpora cavernosa is recommended for counteracting the ischemic effects)B. High-flow (non-ischemic) priapismdue to unregulated arterial blood flow presents with semi-rigid, painless erection Penile or perineal trauma is frequently associated cavernous blood gas values do not reveal hypoxia or acidosis Penile angiography is indicated in high-flow priapism and not in low-flow, painful priapism.Campbell Urology 8/e p845 writes- "Penile arteriography has use as an adjunctive study to identify the presence and site of a cavernous artery fistula in the patient with nonischemic priapism. At this time, arteriography is not routinely used for diagnosis and is otherwise usually performed as part of an embolization procedure." About other options Peyronie's diseaseIt is also k/a penile fibromatosis It is due to fibrous plaques in one or both corpus cavernosum. They may later calcify or ossify. It affects middle-aged and older men. Patients present with complaints of painful erection, curvature of the penis, and poor erection distal to the involved area. The penile deformity may be so severe that it prevents satisfactory vaginal penetration. Examination of the penile shaft reveals a palpable dense, fibrous plaque of varying size involving the tunica albuginea. Spontaneous remission occurs in about 50% of cases. Initially, observation and emotional support are advised. If remission does not occur, p-aminobenzoic acid powder or tablets or vitamin E tablets may be tried for several months. However these medications have limited success. Surgery is done in refractory cases-Excision of the plaque with replacement with a dermal or vein graft or tunica vaginalis graft. Penile prosthesis can be inserted after plaque incision.We are not quite sure about use of penile angiography in Peyronie' s disease.Campbell's Urology 8/e p826 writes about Peyronie's disease - "Currently, the use of vascular testing is variable. Some centers perform duplex Doppler testing on all patients with Peyronie's disease; other centers do not perform vascular testing at all, despite that patients are routinely operated on for Peyronie's disease and, in some cases, receive prostheses as the primary treatment option. At our center, vascular testing is done on all patients who are prospective surgical candidates. Initially, these patients are examined with color Doppler ultrasonography. If the peak systolic velocity, end-diastolic velocity, and resistive index are normal, the patients are not further tested. If the end-diastolic velocity and the resistive indices are not normal, our patients are tested with DICC" What is DICC? DICC or Dynamic Infusion Cavernosometry and Cavernosography are widely accepted as the reference diagnostic techniques for evaluation of veno-occlusive dysfunction. Cavernosometry refers to a method of determining cavernosal pressure response to standardized rates and volumes of fluid infusion in order to define the presence and degree of venous leak. Cavernosography refers to a radiographic demonstration of the corpora cavernosa and their venous effluents after intracavernosal injection of dilute contrast agent. Cavernosometry and cavernosography as angiographic techniques which along with arteriography constitute the gold standard for diagnosis of vasculogenic impotence. But Campbell's urology mentions DICC separate from selective penile angiography. Thus we are not very sure about Peyronie's disease. But we are dead sure, painful priapism is not an indication for penile angiography Erectile dysfunction"Penile arteriography is another invasive test mainly used prior to penile surgical revascularization in young men with posttraumatic surgical revascularization in young men with posttraumatic or congenital arteriogenic erectile dysfunction with on vascular risk factors, or in studying cases of high flow priapism."- Handbook of Sexual and Gender Identity Disorders By David L Rowland, Luca Incrocci p55A-V malformationWell, penile A-V malformation is quite rare. I could not find any documented evidence for use of penile angiography in A-V malformation, but its use is quite self-evident.