Priapism and Sickle Cell

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Priapism is an unusual erection of the penis that is frequently painful and distressing. These are not associated with normal sexual function or desire. Most males with sickle cell anaemia are likely to experience a priapism in their life time.

There are two common types of priapism: 

· Stuttering 

· Acute

The most common type of priapism is a stuttering priapism. It is called stuttering because it keeps reoccurring. Stuttering priapism attacks usually get better by themselves, but spontaneously reoccur again in a few minutes or within couple of hours. Some episodes of stuttering priapisms are not painful; however, the longer the stuttering priapism lasts the more painful the erections become. Stuttering priapism may go on to develop into a more severe attack of acute priapism. 

This is a sustained painful erection lasting more than a few hours. This type of priapism will often not resolve spontaneously. Acute priapism is normally very painful and is considered a major complication of sickle cell disease. It needs emergency medical attention. Patients often experience episodes of stuttering priapism before an attack of acute priapism. 

Sickled red blood cells block the supply and flow of blood in the penis. The sickled red blood cells cause a disruption to the normal flow of blood within the penis. Consequently, the penis becomes starved of oxygen and this causes pain and tissue damage within the penis. 

The tissues within the penis can become scarred and damaged because of frequent episodes of stuttering priapism, or, more commonly, following a prolonged episode of acute priapism (lasting four hours or more). Scarring and damage to the tissue within the penis can then disrupt the normal flow of blood into the penis and this may result in a loss of normal sexual function (erectile dysfunction).

Knowledge of this severe complication of sickle cell disease is often very poor. People with Sickle Cell are therefore not fully aware of the risks associated with episodes of priapism and often reluctant to talk about priapism because of shyness and embarrassment. Sickle cell patients have found it difficult to discuss the issue with female health care professionals, partners and friends. If you are affected by priapism please talk to your GP.