Priapism in sickle-cell disease: a hematologist's perspective.
- Gregory J Kato
- The journal of sexual medicine
BACKGROUND Priapism is a persistent, often painful, purposeless penile erection, which amy or may not be associated with sexual desire, excitement stimulation, or intercourse. OBJECTIVE To present the outcome of management of acute prolonged priapism in patients with homozygous sickle cell disease. METHODS Fifty-four patients seen over a 20-year period were studied. Of these, 35 were treated surgically with Ebbehoj's cavernosa-glandular shunt while 19 were treated conservatively. The information documented for each patient included age, haemoglobin genotype, duration of priapism before treatment , time of onset, previous history of priapism and possible aetiological factors. RESULTS The age range 2.5-38 years with a mean of 20.56 + or - 9.33 years. The potency rate in those treated conservatively was 47.37% while it was 70.37% in those treated surgically. The potency rate in those treated conservatively was 47.37% while it was 70.37% in those treated surgically. The potency rate decreased with increasing duration of priapism before treatment. Those treated within three days had a significantly better outcome than those treated after three days. (chi(2)=4.2986, P=0.038). The potency rate also decreased with increasing age at onset but there was no statistically significant difference between the potency rate in the age groups. CONCLUSION Surgical treatment of acute prolonged priapism may be associated with a higher potency rate compared to conservative treatment. There is an inverse relationship between the potency rate and duration of priapism before treatment and age at onset of Priapism. Acute prolonged priapism is a common cause of impotence in patients with homozygous sickle cell disease.