Bennett Nelson, Mulhall John
Memorial Sloan-Kettering Cancer Center-Urology, New York, NY, USA;.
Weill Medical College of Cornell University-Urology, New York, NY, USA.
J Sex Med. 2008 May;5(5):1244-1250. doi: 10.1111/j.1743-6109.2008.00770.x. Epub 2008 Feb 25.
Priapism is associated with sickle cell disease (SSD); however, few men receive education about this condition, which contributes to attenuated return of functional erections.
To define the demographics, SSD status, and treatment outcomes of African-American men presenting with priapism.
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.
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.
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.
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.
阴茎异常勃起与镰状细胞病（SSD）相关；然而，很少有男性接受过关于这种情况的教育，这导致功能性勃起恢复减弱。
确定出现阴茎异常勃起的非裔美国男性的人口统计学特征、SSD状态和治疗结果。
对阴茎异常勃起男性的人口统计学特征、病史、镰状细胞状态的自我报告以及使用国际勃起功能指数（IIEF）进行的结果评估进行回顾性分析。
对39例非裔美国男性静脉闭塞性阴茎异常勃起病例进行回顾。查阅病历以了解人口统计学特征、病史，包括患者自我报告的SSD状态、血清血红蛋白电泳结果以及阴茎异常勃起的治疗和结果。
出现阴茎异常勃起发作的平均持续时间为22±12小时（6 - 70小时）。8%的男性阴茎异常勃起持续时间<12小时，59%为12 - 24小时，22%为24 - 36小时，11%>36小时。所有阴茎异常勃起持续时间>12小时的患者均抱怨勃起硬度下降。阴茎异常勃起持续时间>36小时的患者无自发功能性勃起恢复，但44%（24 - 36小时）、78%（12 - 24小时）和100%（<12小时）的患者在使用或不使用西地那非的情况下能够产生功能性勃起。随访时IIEF勃起功能领域评分与功能性勃起发生率平行。28%的患者需要进行阴茎分流手术。只有5%的男性记得了解到阴茎异常勃起是SSD的一种并发症。6名男性否认有SSD病史；然而，血红蛋白电泳显示其中4名男性血红蛋白S异常且血红蛋白F水平升高。
SSD与静脉闭塞性阴茎异常勃起的关联在医学界是众所周知的，但很少有患者接受过关于这种情况紧急性质的教育。大多数男性就诊延迟，且很大一部分患者需要进行分流手术，导致长期勃起功能障碍。在那些否认患有SSD的患者中，三分之二通过血红蛋白电泳确诊患有SSD。
