Search Results (4)

Background and Objectives: Priapism, most commonly the ischemic (low-flow) type, is a debilitating complication affecting males with sickle cell disease (SCD), making prevention a critical aspect of care. This study aimed to determine the prevalence of priapism and identify its associated predictors among adult patients with SCD. Materials and Methods: This cross-sectional study was conducted at the Hereditary Blood Disorder Centre in the Eastern Province of Saudi Arabia from February 2024 to August 2025. Results: A total of 240 male SCD patients were included, of whom 33 (13.8%) reported a lifetime history of priapism. The median age at the first priapism episode was 29 years. Multivariate logistic regression identified a history of blood transfusion as the only significant independent predictor of priapism (aOR = 10.36, 95% CI: 1.32–81.14, p = 0.026). Episode frequency varied, with 33.3% of affected patients reporting episodes occurring monthly or less than weekly. Regarding timing, 45.5% of episodes occurred during sleep, while 27.3% occurred in the early morning hours. Kaplan–Meier survival curves indicated that patients receiving hydroxyurea experienced priapism at significantly younger ages compared with non-users (95% CI: 23–33 years). This difference was confirmed by a statistically significant log-rank test (p = 0.012), indicating a more rapid decline in the probability of remaining priapism-free with increasing age among hydroxyurea users. Conclusions: Priapism in SCD remains a significant clinical challenge despite available therapeutic options. Transfusion burden, alongside previously recognized predictors, serves as a key indicator of priapism risk and underscores the importance of early identification and intervention. Although hydroxyurea is effective in managing several complications of sickle cell disease, priapism was observed in patients despite its use, and episodes continued to occur with increasing age; however, these findings may be influenced by confounding factors such as age, disease severity, and transfusion history. Full article

Background and Objectives: Priapism is a condition characterized by a prolonged erection lasting over four hours, either independent of or following sexual stimulation. The primary treatment goal for ischemic and non-ischemic priapism is timely and appropriate intervention in order to preserve erectile function and penile length. This study aims to evaluate the management of recurrent ischemic priapism in sickle cell disease (SCD) patients in an endemic region and compare it with ischemic priapism of other etiologies. Materials and Methods: Patients admitted to our hospital with a diagnosis of priapism between January 2010 and June 2024 were retrospectively reviewed. The patients were divided into two groups: ischemic priapism due to SCD and ischemic priapism due to other etiologies. Patient characteristics, treatment management, and the need for penile prosthesis (PP) were compared. Results: A total of 40 ischemic priapism patients were included in the study; 20 of them had SCD and the other 20 had priapism cases due to different etiologies. In the SCD priapism group, the rate of comorbidity and previous history of priapism were significantly (p < 0.05) higher than in the other etiologies of priapism group. Similarly, in the SCD priapism group, the hospital admission time and the rate of fibrosis findings in MRI (magnetic resonance imaging) were significantly (p < 0.05) higher than in the other priapism groups. The PP implantation rate in the SCD priapism group was found to be significantly (p < 0.05) higher than in the other priapism group. Conclusions: This study highlights the importance of early intervention and patient awareness in SCD-related ischemic priapism, recommending educational programs to improve symptom recognition and prevent complications. Full article

A 5-year-old recently castrated male Doberman dog presented for prolonged erection of one week’s duration with associated pain and dysuria. This was the fourth episode within a year. Each episode was associated with an unusual event, which was stressful for the dog. Castration performed two months prior to the final episode did not prevent recurrence. Due to tissue necrosis, penile amputation and urethrostomy had to be performed. The dog recovered fully. Prolonged erection that persists beyond or that is unrelated to sexual stimulation is called “priapism”. This term refers to the Greek god Priapus, a god of fertility, memorialized in sculptures for his giant phallus. In humans, depending on the mechanism involved, priapism is classified as nonischemic or ischemic. Because prognosis and treatment are different, priapism must be determined to be nonischemic or ischemic. Nonischemic priapism is a rare condition observed when an increase in penile arterial blood flow overwhelms the capacity of venous drainage; it is often associated with penile trauma, and does not require medical intervention. Ischemic priapism is associated with decreased venous return. In humans, ischemic priapism accounts for 95% of cases, the majority of which are idiopathic. Ischemic priapism is a urological emergency; simple conservative measures such as aspiration of blood from the corpora cavernosa and intracavernosal injection of an adrenergic agent are often successful. Stuttering priapism, also called recurrent or intermittent priapism, is a particular form of ischemic priapism reported in humans that is characterized by repetitive episodes of prolonged erections. Management consists of treating each new episode as an episode of acute ischemic priapism, and preventing recurrence with oral medications such as dutasteride and/or baclofen, gabapentin, or tadalafil. To the authors’ knowledge, this case is the first report of stuttering priapism in a dog. Full article

A 14-year-old neutered male British shorthair cat presented with a 21-day history of persistent erection and dysuria, along with overgrooming of the perineal region. Mild palpation induced pain and rigid corpora cavernosa with flaccid glans were observed during physical examination. Ultrasonography of the penis did not detect significant blood flow in the penile cavernosal artery. The drawing of aspirate blood from cavernosal bodies for gas analysis was impossible because of the anatomically small penis size of cats. Conservative management, including topical steroid ointment, lidocaine gel, gabapentin, and diazepam, was prescribed for supportive management. The clinical signs resolved, and ultrasonographic examination of the penis revealed no abnormalities. The cat remains clinically well without recurrence during the 6 months after treatment. To our knowledge, this is the first report of non-ischemic priapism in a cat. Full article