Priapism in sickle cell anemia is of the ischemic type and occurs due to the vaso-occlusion of the vessels that drain venous blood from the penis. This is an emergency and requires rapid medical intervention to avoid permanent sequelae. Learn more.
Why is sickle cell anemia a risk factor for priapism?
Men with sickle cell anemia are more at risk of developing priapism than those who do not have this blood disorder.
In sickle cell anemia, red blood cells, which are normally flexible and rounded, become rigid and assume a sickle shape due to genetic factors.
When this happens, these cells can block the blood vessels of the penis, preventing the proper flow of blood in this region, including the corpora cavernosa, responsible for erection, which causes priapism.
What type of priapism most affects patients with sickle cell anemia?
The ischemic priapism is the one that most affects patients with sickle cell anemia.
This type of priapism is characterized precisely by the interruption of adequate blood flow inside the penis, causing the blood to leave the interior of the corpora cavernosa to end the erection.
There is also ischemic priapism, which is caused by increased blood flow to the penis. However, this is uncommon in cases of patients with sickle cell disease.
Symptoms of ischemic priapism
Priapism is an erection that occurs without sexual stimulus. That is, even when the man is not thinking or in a sexual situation, he presents:
- Prolonged erection that lasts more than three hours;
- Intense pain in the penis during erection;
- Less rigid glans compared to the penile shaft;
- Increased sensitivity in the penile region, with pain and discomfort when handling the penis;
- Change in the coloration of the penis, which may become darker due to lack of oxygenation.
Recommended treatments for priapism
Men with symptoms of priapism should seek medical help immediately so that treatment can be started to avoid permanent damage to penile tissue and preserve erectile function.
The treatment initially consists of aspirating the trapped blood. This is done with a needle inserted directly into the penis, which, in addition to restoring blood flow and oxygenation, helps reduce pressure and relieve pain.
In some cases, vasoconstrictor medications are needed to reduce blood flow and facilitate blood drainage, in addition to intravenous hydration and oxygenation, which help improve circulation and oxygenation of the tissues. If there is a lot of pain, the doctor may administer pain relievers.
Priapism in sickle cell anemia may also require blood transfusions. This step is performed to decrease the number of sickle cells blocking the blood vessels.
Surgery to create a shunt (bypass) and redirect blood flow may also be considered for patients with the hematologic disorder.
Seeking priapism treatment quickly is very important to avoid serious complications. Otherwise, the man may end up with permanent damage, as there is death of penile tissue, causing erectile dysfunction.
What to do if priapism causes erectile dysfunction?
When a patient is left with priapism sequelae in sickle cell anemia, he will likely need treatment for erectile dysfunction, thus restoring his sexual health.
A urologist will help find the best treatment option for each patient.
In cases of priapism, as tissue necrosis occurs, in most cases, the most appropriate treatment for the man is the placement of a penile prosthesis, since medications or injections are not indicated for significant compromise in penile circulation.
The penile prosthesis is placed during surgery. It can be of the malleable or inflatable model, according to the conversation between the patient and the surgeon.
It is important that the implant has the largest possible size and caliber for the anatomy of the penis in question, as respecting the proportions will give more firmness for penetration.
After the recovery period, which varies between 45 and 60 days, the man will be discharged to have sex again. As the erection will be provoked by activating the prosthesis and the penile tissues have already been damaged by priapism, there is no chance of a new episode of prolonged and painful erection happening.
Developing priapism in sickle cell anemia is a risk for men living with the disorder. Therefore, it is necessary to be aware of the symptoms and seek immediate medical assistance when an erection lasts more than three hours without sexual stimuli.
Ischemic priapism has treatment, and it is possible to avoid permanent erectile dysfunction if help is quick. However, if not possible, the sequelae for sexual health can be treated in another way, with a penile implant, which will give the rigidity that the man needs for sexual relations.
If this is your case, contact us and receive a pre-analysis of your case to regain your sexual quality of life.
