title: Oral phosphodiesterase type 5 inhibitors alleviate recurrent priapism complicating thalassemia intermedia: a case report.
abstract: BACKGROUND
  Recurrent ischemic priapism still remains a serious and difficult to treat complication of certain hematological disorders. Elucidation of the underlying pathophysiologic mechanisms and application of new effective prophylactic treatments are needed.
  
  
  OBJECTIVE
  To present the efficacy of phosphodiesterase type 5 inhibitors (PDE5is) as a preventive measure against ischemic priapism recurrences complicating thalassemia intermedia.
  
  
  METHODS
  We report on the case of a 19-year-old Caucasian man with thalassemia intermedia complicated by recurrent episodes of priapism following therapeutic splenectomy. After failure of conventional measures to control recurrences, a trial of long-term PDE5is use was initiated.
  
  
  METHODS
  PDE5is efficacy based on clinical patient history.
  
  
  RESULTS
  Within 2 months of PDE5i preventive strategy, priapism recurrences nearly resolved. At 6 months, prophylaxis was discontinued. At 12 months, the patient reported clear improvement and satisfaction, experiencing rare episodes of priapism and a physiologic erectile function.
  
  
  CONCLUSIONS
  PDE5 dysregulation seems to be an underline pathogenetic mechanism of thalassemia intermedia-associated priapism. It appears that PDE5is might have a role in the clinical management of such patients and their preventive efficacy warrants further testing in clinical trials.
authors.affiliation: Department of Urology, University of Thessaly School of Medicine, Mezourlo, Larissa, Greece. tzorvas@otenet.gr
authors.forename: Vassilios
authors.initials: V
authors.lastname: Tzortzis
authors.forename: Lampros
authors.initials: L
authors.lastname: Mitrakas
authors.forename: Stavros
authors.initials: S
authors.lastname: Gravas
authors.forename: Charalampos
authors.initials: C
authors.lastname: Mamoulakis
authors.forename: Andreas
authors.initials: A
authors.lastname: Meissner
authors.forename: Despina
authors.initials: D
authors.lastname: Kyriakou
authors.forename: Michael D
authors.initials: MD
authors.lastname: Melekos
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000740:Anemia; D006801:Humans; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011317:Priapism / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D055502:Secondary Prevention; D013156:Splenectomy / Q000009:adverse effects*; D017086:beta-Thalassemia / Q000150:complications* / Q000503:physiopathology; D055538:delta-Thalassemia / Q000150:complications* / Q000503:physiopathology
chemical_list: D010726:Phosphodiesterase Inhibitors