Men with sickle cell disease experience greater sexual dysfunction when compared with men without sickle cell disease

Abstract

Recurrent ischemic priapism is a common complication of sickle cell disease (SCD). We assessed the burden, characteristics, and types of priapism, including sexual dysfunction, in a cohort of men with and those without SCD, to test the hypothesis that sexual dysfunction is more prevalent in men with SCD. In Kano, Nigeria, we conducted a comparative cross-sectional survey that included 500 and 250 men 18 to 40 years of age, with and without SCD, respectively. The survey used the Priapism Questionnaire and the International Index of Erectile Function for sexual function assessment. All eligible participants approached for the study gave informed consent and were enrolled. Stuttering and major priapism were defined based on the average duration of priapism experiences that lasted ≤4 and >4 hours, respectively. The prevalence of priapism was significantly higher in men with SCD than in those without it (32.6% vs 2%; P < .001). Stuttering priapism accounted for 73.6% of the priapism episodes in men with SCD. Nearly 50% of the participants with SCD-related priapism had never sought medical attention for this complication. The majority of the men with SCD-related priapism used exercise as a coping mechanism. Priapism affected the self-image of the men with SCD, causing sadness, embarrassment, and fear. The percentage of the men with SCD who had erectile dysfunction was more than twofold higher than that of those without SCD who had erectile dysfunction (P = .01). The men with SCD had a higher prevalence of priapism and sexual dysfunction than the men without SCD.

Economic evaluation of regular transfusions for cerebral infarct recurrence in the Silent Cerebral Infarct Transfusion Trial

“…Similarly, for symptomatic avascular necrosis of the femoral head, the incidence rate ratio was 0.22 (P=0.02) with an incidence rate of 0.49 and 2.25 events per 100 patient-years, respectively. A significantly lower incidence rate of priapism and symptomatic avascular necrosis would lead to high additional cost savings over time [39][40][41][42][43][44] , resulting in regular blood transfusions being more cost-effective if they were included in the analysis. Since we did not include these costs, our cost-effectiveness model for transfusion therapy is conservative.…”

Fertility preservation for pediatric patients with hemoglobinopathies: Multidisciplinary counseling needed to optimize outcomes

“…Vaso-occlusion of the corpus cavernosum can result in priapism and repeated vasoocclusive episodes with priapism can result in high rates of erectile dysfunction, with some studies demonstrating as many as 48% of men will have impaired erectile function at an average age of 28 years old ( 18 ). Priapism is a true SCD emergency as the risk of erectile dysfunction increases with prolonged episodes of priapism ( 19 , 20 ). Severe cases of erectile dysfunction can make spontaneous reproduction difficult and limit future fertility and may even require penile prosthesis to achieve an erection necessary for intercourse.…”

Epidemiology and treatment of priapism in sickle cell disease

“…Sickle cell dis ease (SCD) is asso ci ated with priapism, a per sis tent pain ful erec tion occur ring with or with out sex ual desire. 1,2 Priapism related pain is a car di nal fea ture of ische mia (low fl ow) due to com part ment syn drome. In con trast, nonischemic (high fl ow) priapism results from a trauma related arte rial injury.…”

“…3 In chil dren and adults with SCD, ische mic priapism is the most com mon pre sen ta tion (95 % ), 4 reported at least once in approx i ma tely 33 % of ado les cents and adults with SCD. 1 Approximately 74 % of the priapism epi sodes are the stuttering (recur rent) type, last ing for a sev eral hour dura tion or less, which remits and relapses with or with out med i cal inter ven tion. 1 Priapism occurs less com monly in chil dren youn ger than 18 years (3.6 % ).…”

“…1 Approximately 74 % of the priapism epi sodes are the stuttering (recur rent) type, last ing for a sev eral hour dura tion or less, which remits and relapses with or with out med i cal inter ven tion. 1 Priapism occurs less com monly in chil dren youn ger than 18 years (3.6 % ). 1,2 Genome wide asso ci a tion stud ies have reported an asso ci a tion between priapism and poly mor phism in genes of transform ing growth fac tor -β recep tor ( TGFBR3 ), sub unit of fac tor VIII, integrin α V, aquaporin, and Klotho gene.…”