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November 1980

Priapism and Impotence in Homozygous Sickle Cell Disease

Author Affiliations

From the Medical Research Council Laboratories, University of the West Indies, Kingston, Jamaica (Drs Emond, Holman, and Serjeant), and the London School of Hygiene and Tropical Medicine (Dr Hayes). Dr Emond is now with the Department of Neurology, Maudsley Hospital, London. Dr Holman is now with London Hospital Medical Center.

Arch Intern Med. 1980;140(11):1434-1437. doi:10.1001/archinte.1980.00330220022011

• A questionnaire study of Jamaican patients with homozygous sickle cell (SS) disease indicated a 42% prevalence of priapism, with a median age at onset of 21 years. Two predominantly different patterns of priapism were recorded: short "stuttering" episodes lasting less than three hours, with normal consequent sexual function, and severe prolonged attacks (generally more than 24 hours) commonly followed by impotence. Stuttering episodes were frequently a prodrome to a major attack. Over one fourth of those who had suffered priapism had some degree of impotence. Hematologic analysis indicated that priapism was significantly associated with low hemoglobin F levels and high platelet counts. Patients with severe attacks of priapism had lower hemoglobin F levels and reticulocyte count, and a higher mean corpuscular volume, than patients with only stuttering episodes. Priapism and impotence contribute to the morbidity of SS disease more frequently than previously recognized.

(Arch Intern Med 140:1434-1437, 1980)