Preventive treatment of priapism in sickle cell disease with oral and self-administered intracavernous injection of etilefrine.
OBJECTIVE
Priapism is a common and currently unsatisfactorily managed complication of sickle cell disease (SCD). In June 1994, 6 SCD patients received a new therapeutic regimen to prevent the occurrence and recurrence of priapism.


METHODS
The patients (5 with SS and 1 with SC) were adults and had frequent episodes of stuttering priapism (SP), and two of them had had acute episodes (AP) lasting more than 3 hours. The treatment consists of preventive oral administration of the alpha-adrenergic agent etilefrine, and self-administered intracavernous injection (SICI) of the same agent to reverse episodes lasting more than 1 hour.


RESULTS
Since the beginning of treatment, all patients were protected against AP, 4 patients had no recurrence with the oral treatment alone, 2 had to use SICI, 1 occasionally and 1 constantly. There was no modification of sexual activity and no complications. Blood pressure was unaffected.


CONCLUSIONS
This treatment is simple, cheap, and self-administered. It should be proposed to all patients with SCD in all geographic areas as part of an educational program for active prevention of this severe complication.
Virag
R
R
Centre d'Explorations et de Traitements de l'Impuissance, Paris, France.
Bachir
D
D
Lee
K
K
Galacteros
F
F
D000284:Administration, Oral; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications; D005039:Etilefrine / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D010413:Penis; D011317:Priapism / Q000209:etiology / Q000517:prevention & control*; D012646:Self Administration
D000316:Adrenergic alpha-Agonists; D005039:Etilefrine