Priapism Complication In Sickle Cell Disease

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Priapism is a complication developed in sickle cell disease patients, in both children and adults that are males only. In patients with sickle cell disease, the sickling of red blood cells can cause an erection of the penis; this is the major cause of priapism. 

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Due to the compromise in blood flow out of the penis because the blood vessels are blocked by sickled red blood cells. When the erection is continuous, it is then called priapism. Priapism is a painful and major condition in sickle cell disease patients. Therefore, priapism is the painful erection of the penis that stays for an extended period of time. 

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Picture Credit: Core EM

The erection of the penis in priapism is not due to a sexual stimulus or arousal. Priapism can also be diagnosed at a young age, and when left untreated causes impotency (being unable to have an erection), also infertility (inability to bear children), scarring, or permanent damage to the penis. 

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Picture Credit: Clinical Monster Blog

A normal erection is due to stimulus, where the blood vessels in the penis relax and allow the flow of more blood into the penis, at the same time of occurrence, the other vessels contract and result in reduced blood flow out of the penis, therefore causing an erection. And after the stimulus is removed, the penis returns to its normal nonrigid state, but in priapism, the penis does not return to a non-rigid state after being erected. There are three types of priapism in sickle cell disease: stuttering priapism, acute or prolonged priapism, and chronic priapism. 

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Picture Credit: ResearchGate

Stuttering priapism is a penis erection that lasts longer than thirty minutes but a maximum of two hours. Stuttering priapism maybe occurs once or recurrently, the erection may go away by itself or by the use of medications. Acute or prolonged priapism is an erection episode that lasts a maximum of two hours and above. 

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Picture Credit: Anatomy Exhibits

Medications used in the treatment of acute or prolonged priapism work best in the first four hours. Chronic priapism is a state of semi-erection that lasts for days or weeks. It is usually not painful. 

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