PRIAPISM DUE TO “S” AND “C” HEMOGLOBINOPATHY SUCCESSFULLY TREATED WITH FINASTERIDE
brazjurol.com.br/outubro_2001/Be … 75_477.htm
HELIO BEGLIOMINI
Humanae Vitae Institute of Medicine, São Paulo, SP, Brazil
[b]Priapism is a prolonged painful erection of the corpora cavernosa unaccompanied by sexual desire[/b]. It has been classified into two main groups, primary (idiopathic) and secondary, which are attributed to more than 38 different causes. The more common conditions associated with secondary priapism include sickle cell anemia, trauma, leukemia, cancerous invasion of the penis, drugs, alcohol ingestion, various thromboembolic diseases, and intravenous fat for parenteral nutrition.
Priapism associated with sickle cell anemia was first described in 1934. Recurring periods of prolonged and painful erection, less than tree hours, unrelated to sexual activity are troubling to the patient. Priapism is a complication of sickle cell anemia in 2.4 to 5% of male patients. On the other hand, of the men who seek medical attention for the treatment of priapism 10 to 20% have sickle cell anemia.
[b]We report a 32-year-old black man who was referred by a hematologist with a diagnosis of priapism [/b]due to S and C hemoglobinopathy.
The patient had a 10-year history of nocturnal prolonged and painful erections, lasting in average from 3 to 6 hours (up to 12 hours), and occurring almost every night.
He had already used strong analgesics, such as tramadol cloridrate, to decrease pain during erections. Sexual intercourse did not always reduce erection intensity. He was otherwise healthy and serum electrophoresis demonstrated hemoglobin A1 = 0%, A2 = 4.5%, S = 48.2% and C = 46.4%.
The patient was placed on a regimen of a 5-alpha-reductase inhibitor (finasteride) administered orally 5-mg twice a day. The prolonged and painful erections decreased subjectively in an average of 70% in the first month of treatment.
Key words: priapism; anemia; treatment; sickle cell anemia; finasteride
Braz J Urol, 27: 475-477, 2001