Abstract
Recurrent priapism is prevalent in children. Different medications have been used to avoid new episodes, however, there is no consensus regarding the best option. The use of finasteride to treat priapism in adults has already been tested. The aim of the present study was to test the hypothesis that a low dose of finasteride would be effective in preventing recurrent priapism in children. Since 2007, five children and adolescents with recurrent episodes of priapism have been treated with finasteride in our department, and the medical records of these patients were reviewed for this study. In four cases, the dose used was 1 mg a day, while the remaining patient used 1 mg twice a day. Prior to initiating finasteride treatment, one patient reported having had 6 episodes of acute priapism, while the remaining patients had more than 10 episodes. One of the patients reported having stuttering priapism almost daily. With a mean follow-up of 20 months, four patients had no episodes and only one patient complained of sporadic and shorter duration episodes. These initial results suggest that a low daily dose of finasteride appears to represent an effective and safe form of treatment for recurrent priapism in children and adolescents with SCD. However, in order to confirm these initial findings, studies with a large population and a control group are essential.
Highlights
Priapism is defined as an involuntary erection unassociated with sexual arousal that may be painful and persistent
The aim of the present study is to test the hypothesis that a low dose of finasteride would be effective in preventing recurrent priapism in children
Prior to initiating finasteride treatment, one patient reported having had 6 episodes of acute priapism, while the remaining patients had had more than 10 episodes
Summary
Priapism is defined as an involuntary erection unassociated with sexual arousal that may be painful and persistent. Priapism in children is generally associated with sickle cell disease (SCD) [1,2,3]. The incidence of priapism in children with SCD is estimated to be between 35% and 89% [1,3]. 27% of patients with sickle cell disease between 5 and 20 years of age have at least one episode of priapism and the probability of having at least one episode of priapism by age 20 was reported to be 89%. It is generally presented clinically as a painful, self-limiting event of short duration; recurrent episodes of priapism may result in physical and emotional damage in both children and adults [5]
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