Management of Ischemic Priapism Due to Sickle Cell Disease and Other Etiologies: Treatment Strategies and Indications for Penile Prosthesis Implantation in an Endemic Region

Purpose Priapism is a condition characterized by a prolonged erection lasting over four hours, either independent of or following sexual stimulation. The primary treatment goal for ischemic and non-ischemic priapism is timely and appropriate intervention to preserve erectile function and penile length. This study aims to evaluate the management of recurrent ischemic priapism in SCD patients in an endemic region and compare it with ischemic priapism of other etiologies. Methods Patients who were admitted to our hospital with a diagnosis of priapism between January 2010 and June 2024 were retrospectively screened. Patients were divided into two groups as ischemic priapism due to SCD and ischemic priapism due to other etiologies; the characteristics of the patients, treatment management and penile prosthesis requirement were compared. Results A total of 40 ischemic priapism patients were included in the study; 20 of them had sickle cell disease and the other 20 had priapism cases due to different etiologies. In the SCD priapism group, the rate of comorbidity and previous history of priapism were significantly (p < 0.05) higher than in the other etiologies of priapism group. Similarly, in the SCD priapism group, the hospital admission time and the rate of fibrosis findings in MRI (magnetic resonance) were significantly (p < 0.05) higher than in the other priapism groups. The penile prosthesis implantation rate in the SCD priapism group was found to be significantly (p < 0.05) higher than in the other priapism group. Conclusions This study explored the association between ischemic priapism, SCD, and other etiologies, focusing on treatment approaches and penile prosthesis necessity. Early intervention and patient awareness are essential in SCD-related priapism to prevent complications. Thus, educational programs are recommended to enhance symptom recognition and prompt medical attention.