Emmanuel Anthony, Moussa Ahmed, Kesse-Adu Rachel, Shabbir Majed
Department of Urology, Guy's & St Thomas' Hospital, London, UK.
Department of Haematology, Guy's and St Thomas' Hospital, London, UK.
Int J Impot Res. 2024 Dec 21. doi: 10.1038/s41443-024-01008-z.
Sickle cell disease is one of the most common autosomal recessive genetic disorders with 23% and over 70% of men with this condition, experiencing episodes of ischaemic priapism and stuttering priapism, respectively, with potentially severe consequences. The effective prevention of sickle cell disease induced ischaemic priapism and stuttering priapism requires a multidisciplinary and multimodal approach. A search of the English literature was performed utilising Pubmed® and Google Scholar to identify publications on contemporary and novel treatment options, with their associated treatment outcomes if available, that are utilised to prevent stuttering priapism episodes and hence a fulminant ischaemic priapism. This narrative review focuses on three main aspects which include firstly, patient education and lifestyle modifications. Secondly, strategies aimed at preventing stuttering priapism episodes with traditional treatments such as alpha-adrenergic agonists and hormone manipulation strategies among others. Finally, we review treatments utilised to treat the underlying sickle cell disease with contemporary options such as hydroxyurea to more novel therapies such as crizanlizumab and voxelotor. The role of potentially curative techniques such as gene therapy and stem cell transplantation are also reviewed and summarised.
镰状细胞病是最常见的常染色体隐性遗传病之一,患有这种疾病的男性中分别有23%和70%以上经历过缺血性阴茎异常勃起和间歇性阴茎异常勃起发作,可能会产生严重后果。有效预防镰状细胞病引起的缺血性阴茎异常勃起和间歇性阴茎异常勃起需要多学科和多模式的方法。利用PubMed®和谷歌学术搜索英文文献,以确定有关当代和新型治疗方案的出版物,以及如果有的话,它们相关的治疗结果,这些方案用于预防间歇性阴茎异常勃起发作,从而预防暴发性缺血性阴茎异常勃起。本叙述性综述关注三个主要方面,首先是患者教育和生活方式改变。其次是旨在通过传统治疗方法(如α-肾上腺素能激动剂和激素操纵策略等)预防间歇性阴茎异常勃起发作的策略。最后,我们回顾了用于治疗潜在镰状细胞病的治疗方法,从当代的方法如羟基脲到更新型的疗法如crizanlizumab和voxelotor。还对基因治疗和干细胞移植等潜在治愈技术的作用进行了回顾和总结。