Department of Haematology, Aminu Kano Teaching Hospital/Bayero University, Kano, Nigeria.
Department of Computer Science, Bayero University, Kano, Nigeria.
Blood Adv. 2022 Oct 25;6(20):5676-5683. doi: 10.1182/bloodadvances.2022007285.
We conducted one of the first prospective studies to test the hypothesis that the clinical history of priapism underestimates priapism incidence compared with a priapism pain diary. Eligibility criteria were men with sickle cell anemia (SCA) between 18 and 40 years of age who have had at least 3 episodes of priapism in the past 12 months. Seventy-one men with SCA completed the diary for at least 3 months. The first 3 months of the priapism diary were included in the analysis. A total of 298 priapism episodes were recorded, and 80% (57 of 71) of the participants had at least 1 priapism event. Priapism severity was reported in the range of moderate to the worst imaginable pain in 81.5% (263 of 298), and a total 57 participants (80%) had a median pain rating of 6 (interquartile range: 5-8) on a scale from 1 to 10. The monthly incidence rate of priapism per participant based on history versus self-report pain diary was 2.0 (95% confidence interval, 1.9-2.1) and 1.4 (95% confidence interval, 1.2-1.6), respectively (P < .001). For participants that had a prior priapism episode, 80% had another episode during the 3-month interval follow-up. The median time to that second episode was 27.5 days. Major priapism occurred in 9.9% of episodes and was associated with the sum of all prospective priapism events. Men with SCA and at least 3 priapism episodes in the past 12 months are at significant risk for recurrent priapism in the following 3 months.
我们进行了首次前瞻性研究之一，以检验以下假设：与勃起疼痛日记相比，勃起障碍的临床病史低估了勃起障碍的发病率。入选标准为年龄在 18 至 40 岁之间、过去 12 个月内至少有 3 次勃起障碍发作的镰状细胞贫血（SCA）男性。71 名 SCA 男性至少完成了 3 个月的日记。勃起障碍日记的前 3 个月包含在分析中。共记录了 298 次勃起障碍发作，80%（71 名参与者中的 57 名）至少有 1 次勃起障碍事件。81.5%（263/298）的患者报告勃起障碍严重程度为中度至难以想象的最严重疼痛，共有 57 名参与者（80%）的中位数疼痛评分为 6（四分位距：5-8），评分范围为 1 到 10。根据病史与自我报告疼痛日记，每位参与者每月勃起障碍的发病率分别为 2.0（95%置信区间，1.9-2.1）和 1.4（95%置信区间，1.2-1.6）（P<0.001）。对于有过勃起障碍发作的参与者，80%在接下来的 3 个月随访中有再次发作。第二次发作的中位数时间为 27.5 天。9.9%的发作出现严重勃起障碍，与所有前瞻性勃起障碍事件的总和相关。过去 12 个月内至少有 3 次勃起障碍发作的 SCA 男性在接下来的 3 个月内再次发生勃起障碍的风险显著增加。
