Sickle cell disease status and outcomes of African-American men presenting with priapism
Sickle cell disease status and outcomes of African-American men presenting with priapism
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DOI：
10.1111/j.1743-6109.2008.00770.x
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发表时间：
2008-05-01
影响因子：
3.5
通讯作者：
Mulhall, John
中科院分区：
文献类型：
--
作者：
Bennett, Nelson;Mulhall, John
导言。异常勃起与镰状细胞病(SSD)有关；然而，很少有男性接受这种疾病的教育，这有助于功能勃起功能恢复的减弱。确定出现异常勃起的非裔美国男性的人口学特征、SSD状况和治疗结果。对异常勃起患者的人口学特征、病史、镰状细胞状态的自我报告以及国际勃起功能量表(IIEF)的结果评估进行了回顾。方法：研究方法。本文对39例非裔美国男性闭塞性异常勃起进行了回顾分析。回顾人口统计学、病史，包括患者自我报告的SSD状态、血清血红蛋白电泳结果、异常勃起的治疗和结果。异常勃起的平均持续时间为22+/-12小时(6-70小时)。8%的男性异常勃起持续12小时，59%的男性异常勃起持续12-24小时，22%的男性异常勃起持续24-36小时，11%的男性勃起持续36小时。所有异常勃起事件发生12小时的患者都主诉勃起僵硬程度降低。持续36小时的异常勃起患者无一例恢复功能勃起，但在使用或不使用西地那非的情况下，44%(24-36小时)、78%(12-24小时)和100%(<；12小时)的患者能够产生功能性勃起。随访IIEF勃起功能领域评分与功能性勃起发生率平行。28%的患者需要阴茎分流手术。只有5%的男性回忆起他们了解到异常勃起是SSD的并发症。6名男性否认有SSD病史；然而，血红蛋白电泳法显示其中4名男性的血红蛋白S异常，且Hb F水平升高。SSD与静脉性异常勃起的关系在医学界是众所周知的，但很少有患者接受过关于这种疾病的紧急性质的教育。大多数男性以延迟的方式出现，相当一部分人需要分流手术，导致长期的勃起功能障碍。在那些否认患有SSD的人中，三分之二的人通过血红蛋白电泳法患有SSD。
Introduction. Priapism is associated with sickle cell disease (SSD); however, few men receive education about this condition, which contributes to attenuated return of functional erections.Aim. To define the demographics, SSD status, and treatment outcomes of African-American men presenting with priapism.Main Outcome Measures. Demographics, medical history, self-report of sickle cell status, and outcome assessment using International Inventory of Erectile Function (IIEF) of men with priapism were retrospectively reviewed. Methods. A review of 39 cases of venocclusive priapism in African-American men was conducted. Charts were reviewed for demographics, medical history including SSD status by patient self-report, serum hemoglobin electrophoresis results, and priapism treatment and outcome.Results. Mean duration of presenting priapism episode was 22 +/- 12 hours (6-70 hours). Eight percent of men had priapism for < 12 hours, 59% 12-24 hours, 22% 24-36 hours, and 11% > 36 hours. All patients with priapism events of > 12 hours complained of reduction in erectile rigidity. No patients with priapism > 36 hours duration had return of spontaneous functional erections, but 44% (24-36 hours), 78% (12-24 hours) and 100% (< 12 hours) were able to generate functional erections with or without the use of sildenafil. Follow-up IIEF erectile function domain scores paralleled incidence of functional erections. Penile shunt surgery was required in 28%. Only 5% of men recalled learning that priapism was a complication of SSD. Six men denied a history of SSD; however, hemoglobin electrophoresis revealed abnormal hemoglobin S and elevated hemoglobin F levels in four of these men.Conclusions. The association of SSD and venocclusive priapism is well known in the medical community, yet few patients ever receive education regarding the emergency nature of the condition. The majority of men presents in a delayed fashion, and a significant proportion requires shunt surgery leading to long-term erectile dysfunction. Of those who denied having SSD, two-thirds had SSD by hemoglobin electrophoresis.