Priapism Associated with Sickle Cell Hemoglobinopathy in Children: Long-Term Effects on Potency

Chakrabarty, Amit; Upadhyay, Jyoti; Dhabuwala, C.B.; Sarnaik, Sharada A.; Perlmutter, Alan D.; Connor, John P.

doi:10.1016/s0022-5347(01)66298-0

Cited by 39 publications

(32 citation statements)

References 21 publications

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“…More invasive approaches such as surgery to decompress the corpora cavernosa are restricted to the refractory acute attacks. (11,14). The recurrence of the acute episodes is common.…”

Section: Discussionmentioning

confidence: 99%

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Finasteride for recurrent priapism in children and adolescents: a report on 5 cases

2012

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“…More invasive approaches such as surgery to decompress the corpora cavernosa are restricted to the refractory acute attacks. (11,14). The recurrence of the acute episodes is common.…”

Section: Discussionmentioning

confidence: 99%

“…Finasteride is currently considered an alternative prophylactic treatment for recurrent priapism in adults (6,12,14). This drug acts by inhibiting the type 2 isoform of the 5 alpha-reductase enzyme, which is responsible for the conversion of testosterone into dihydrotestosterone predominantely in hair follicles and the prostate (6).…”

Section: Discussionmentioning

confidence: 99%

Finasteride for recurrent priapism in children and adolescents: a report on 5 cases

2012

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“…Children with sickle cell anemia [3] are at a higher risk of developing erectile dysfunction. Interestingly, Dewan et al [25] reported that among children with sickle cell anemia-associated priapism, restoration of potency was 100% with conservative treatment, whereas it was only 27% with surgical management.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous priapism in adults is predominantly (75%) of idiopathic origin, whereas in children, sickle cell anemia is the leading cause (67%) of it [2]. About 6% of children with sickle cell anemia are complicated with priapism [3]. It is estimated that 80% to 98% of children with sickle cell anemia develop at least one episode of priapism before 20 years of age [4].…”

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confidence: 99%

A modification of Winter's shunt in the treatment of pediatric low-flow priapism

Raveenthiran

2008

Journal of Pediatric Surgery

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“…O prognóstico pode ser melhor para pré-púberes 20 . Não conseguimos encontrar explicações para esse fenômeno, mas talvez a ausência de atividade androgênica pudesse explicar a proteção relativa de pacientes antes da puberdade.…”

Section: Prognósticounclassified

Priapism in children: review of pathophysiology and treatment

Jesus¹,

Dekermacher²

2009

J Pediatr (Rio J)

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Objective: Priapism may cause serious sequelae concerning the future sex life of the patient, as it can determine impotence, erectile dysfunction or psychogenic sexual aversion. It is a common symptom of sickle cell disease in children and adolescents. There are few good quality evidence manuscripts about the problem in current medical literature. Sources:Literature review on the databases MEDLINE and LILACS covering the period from 1966 to 2008. Summary of the findings:The basis for the treatment of low flow priapism includes treating sickle cell disease and the usage of intracavernous adrenergic agents as necessary. Surgery is indicated in a minority of cases. The treatment of pediatric cases demands dose adjustments, adequate drug choice and sedoanalgesia to cover procedures involving pain or trauma. Conclusions:A new physiopathologic theory concerning sickle cell disease, which questions the traditional vascular blockage mechanisms by deformed red cells and proposes that endothelial inflammatory activation is the main cause of clinical problems, allows to propose new therapeutic maneuvers to solve sickle cell priapism. The absence of good quality evidence to treat sickle cell priapism suggests the necessity to conduct good prospective multicenter protocols to investigate the condition.J Pediatr (Rio J). 2009;85(3):194-200: Priapism, sickle cell disease, children. ResumoObjetivo: O priapismo pode causar sequelas graves em relação à vida sexual futura do paciente, pois pode determinar impotência, disfunção erétil ou aversão sexual psicogênica. É um sintoma comum da doença falciforme em crianças e adolescentes. Há poucos estudos com evidências de qualidade sobre esse problema na literatura médica atual. Fontes dos dados:Revisão da literatura utilizando as bases de dados MEDLINE e LILACS no período de 1966 a 2008. Síntese dos dados:A base para o tratamento de priapismo de baixo fluxo inclui o tratamento da doença falciforme e o uso de agentes adrenérgicos por administração intracavernosa conforme necessário. Indica-se cirurgia em uma minoria de casos. O tratamento de casos pediátricos exige ajuste de doses, escolha adequada de medicamentos e sedoanalgesia para procedimentos envolvendo dor ou trauma. Conclusões:Uma nova teoria fisiopatológica relativa à doença falciforme, que questiona os mecanismos tradicionais de bloqueio vascular por hemácias deformadas e propõe que a ativação inflamatória endotelial é a principal causa de problemas clínicos, permite propor novas manobras terapêuticas para lidar com o priapismo na doença falciforme. A ausência de evidência de qualidade para tratar o priapismo na doença falciforme sugere a necessidade de conduzir bons protocolos prospectivos multicêntricos para investigar essa condição.J Pediatr (Rio J). 2009;85(3):194-200 Artigo submetido em 22.09.08, aceito em 12.11.08.

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Priapism Associated with Sickle Cell Hemoglobinopathy in Children: Long-Term Effects on Potency

Abstract: Shunts performed within 48 hours, especially in postpubertal children, seemed more likely to preserve potency.

Cited by 39 publications

References 21 publications

Finasteride for recurrent priapism in children and adolescents: a report on 5 cases

Finasteride for recurrent priapism in children and adolescents: a report on 5 cases

A modification of Winter's shunt in the treatment of pediatric low-flow priapism

Priapism in children: review of pathophysiology and treatment

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