What is the effectiveness of surgical and non-surgical therapies in the treatment of ischemic priapism in patients with sickle cell disease? A systematic review by the EAU Sexual and Reproductive Health Guidelines Panel

M. Gul, B. Luca, Konstantinos Dimitropoulos, P. Capogrosso, U. Milenkovic, A. Cocci, Rajan Veeratterapillay, G. Hatzichristodoulou, V. Modgil, G. I. Russo, Tharu Tharakan, A Kalkanli , Muhammad Imran Omar, Carlo Bettocchi, Joana Carvalho, Giovanni Corona, T. H. Jones, Aras Kadioglu, J. I. Martinez-Salamanca, Ege C. SerefogluPaolo Verze, S. Minhas, Andrea Salonia* (Corresponding Author), EAU Working Group on Sexual and Reproductive Health

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Sickle cell disease (SCD) is an inherited hemoglobin disorder characterized by the occlusion of small blood vessels by sickle-shaped red blood cells. SCD and is associated with a number of complications, including ischemic priapism. While SCD accounts for at least one-third of all priapism cases, no definitive treatment strategy has been established to specifically treat patients with SC priapism. This aim of this systematic review was to assess the efficacy and safety of contemporary treatment modalities for acute and stuttering ischemic priapism associated with SCD. The primary outcome measures were defined as resolution of acute priapism (detumescence) and complete response of stuttering priapism, while the primary harm outcome was as sexual dysfunction. The protocol for the review has been registered (PROSPERO Nr: CRD42020182001), and a systematic search of Medline, Embase, and Cochrane controlled trials databases was performed. Three trials with 41 observational studies met the criteria for inclusion in this review. None of the trials assessed detumescence, as a primary outcome. All of the trials reported a complete response of stuttering priapism; however, the certainty of the evidence was low. It is clear that assessing the effectiveness of specific interventions for priapism in SCD, well-designed, adequately-powered, multicenter trials are strongly required.
Original languageEnglish
Pages (from-to)20-35
Number of pages16
JournalInternational Journal of Impotence Research
Volume36
Issue number1
Early online date8 Aug 2022
DOIs
Publication statusPublished - 1 Feb 2024

Bibliographical note

The authors acknowledge the participants for their cooperation conflict of Interest: None of the authors declare any interest.
Formatting of funding sources: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Data Availability Statement

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Keywords

  • Sickle cell disease
  • ischemic priapism
  • stuttering priapism
  • Erectile dysfunction

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