Samir K Ballas1, David Lyon1. 1. Cardeza Foundation for Hematologic Research, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: Priapism is unwanted painful penile erection that affects about 36% of boys and men with sickle cell disease (SCD) most of whom have sickle cell anemia. Clinically, priapism could be stuttering, minor, or major. The first two types are mild, last < 4 h, are usually treated at home, have good prognosis with normal sexual function. The major type of priapism lasts >4 h, associated with severe pain, requires hospitalization; often does not respond to medical treatment and may require shunt surgery. Untreated major priapism and surgical intervention often cause impotence. In this study, we report our 15-year experience in treating adult patients with SCD and major priapism with blood exchange transfusion after being refractory to other medical therapies. METHODS: Adult male African Americans patients with SCD and major priapism were enrolled in this study and followed for 15 years. A Haemonitics V-50 machine was initially used for whole blood exchange and was later replaced with Cobe Spectra machine for RBC exchange. RESULTS: We used 239 blood exchanges requiring 1,136 RBC units. We maintained a post-exchange hemoglobin level of about 10 g/dL and hemoglobin S level < 30%. None of the patients had any neurological complications such as headache, seizures, neurological deficits, or obtundation post-exchange. CONCLUSION: Together, the data indicate that blood exchange transfusion for the treatment of patients with SCD and major priapism is efficacious and safe.
BACKGROUND:Priapism is unwanted painful penile erection that affects about 36% of boys and men with sickle cell disease (SCD) most of whom have sickle cell anemia. Clinically, priapism could be stuttering, minor, or major. The first two types are mild, last < 4 h, are usually treated at home, have good prognosis with normal sexual function. The major type of priapism lasts >4 h, associated with severe pain, requires hospitalization; often does not respond to medical treatment and may require shunt surgery. Untreated major priapism and surgical intervention often cause impotence. In this study, we report our 15-year experience in treating adult patients with SCD and major priapism with blood exchange transfusion after being refractory to other medical therapies. METHODS: Adult male African Americans patients with SCD and major priapism were enrolled in this study and followed for 15 years. A Haemonitics V-50 machine was initially used for whole blood exchange and was later replaced with Cobe Spectra machine for RBC exchange. RESULTS: We used 239 blood exchanges requiring 1,136 RBC units. We maintained a post-exchange hemoglobin level of about 10 g/dL and hemoglobin S level < 30%. None of the patients had any neurological complications such as headache, seizures, neurological deficits, or obtundation post-exchange. CONCLUSION: Together, the data indicate that blood exchange transfusion for the treatment of patients with SCD and major priapism is efficacious and safe.
Authors: S Minhas; A Salonia; M Gül; B Luca; K Dimitropoulos; P Capogrosso; U Milenkovic; A Cocci; R Veeratterapillay; G Hatzichristodoulou; V Modgil; G I Russo; T Tharakan; A Kalkanli; M I Omar; C Bettocchi; J Carvalho; G Corona; T H Jones; A Kadioglu; J I Martinez-Salamanca; E C Serefoglu; P Verze Journal: Int J Impot Res Date: 2022-08-08 Impact factor: 2.408
Authors: B F Faye; D Sow; M Seck; N Dieng; S A Toure; M Gadji; A B Senghor; Y B Gueye; D Sy; A Sall; T N Dieye; A O Toure; S Diop Journal: Adv Hematol Date: 2017-05-11