Demography of Priapism: Comparison between Sickle Cell and Non-Sickle Cell Disease Patients

Abstract

Objectives: priapism is a relatively rare complication of sickle cell disease(SCD). In this study we aim to define the demography and risk factors for recurrent episodes of priapism in SCD and non-SCD patients. Methods: data on 28 males with priapism were retrospectively retrieved. The demographical, clinical, hematological, and biochemical parameters, management and its complications were studied. Comparison between SCD and non-SCD groups were done using statistical methods. Results: priapism patients were mostly adults (82%), presented at a young age (26 years). SCD was the most important cause of priapism (60.7%), painful erection (78.6%) the most common presentation, with median frequency of priapism episodes significantly higher in SCD than non-SCD patients (P= 0.004). SCD patients had significantly lower mean of Hb (P=0.001) and higher mean of WBC (P=0.011), platelets (P=0.017), ALT (P=0.011), bilirubin (P= 0.003) and LDH (P= 0.027) than non-SCD patients. For medical therapy 50% had hydroxyurea and blood transfusion; while for surgical therapy 17.9% had distal penile shunt with a complications rate of 28.6% (7% penile hematoma, 14.3% erectile dysfunction).As an outcome, 32% had detumescence, 14.3% persistent priapism, and 53.6% recurrent priapism. Conclusion: sickle cell disease is the major risk factor for ischemic and stuttering priapism. Patients with SCD presented with priapism were young adults with low Hb, high WBC, platelets, bilirubin, ALT and LDH. These findings can be used to monitor priapism patients at presentation to predict those who are at risk of recurrent episodes to prevent the complications of pain and erectile dysfunction.