Priapism in South West Nigeria-Short and Intermediate-Term Outcomes.

Abstract

Background: Priapism is usually defined as penile erection that lasts more than 4 h beyond sexual stimulation and orgasm or is unrelated to sexual stimulation. The overwhelmingly more common low-flow priapism is typically painful, while high-flow priapism is typically painless. Interventions are varied depending on the aetiology and timing of the presentation. The outcome in most cases depends on the timing of the intervention.

Objective: This study aimed to review the presentation and short- and intermediate-term outcomes of treatment of priapism in patients in Southern Nigeria.

Materials and methods: This was a retrospective 10-year study conducted from 2010 to 2019 of all adult patients diagnosed with priapism who were admitted to the adult urology units in two Government University Teaching hospitals in South West Nigeria.

Results: The records of 61 patients were analysed. The mean age was 27.54 years ± 6.22 with a range of 15-56 years. The median duration of symptoms before presentation was 36 h with a range of 2 to 336 h. Eleven patients (18%) presented within 24 h of onset of symptoms. Sickle cell disease (SCD) and idiopathic aetiology were the most common causes of priapism, accounting for 44 (72.1%) and 8 (13.1%) respectively. Corporal aspiration resolved the priapism in 22 (36.1.%), while corpora-glandular shunt was the final treatment in 36 (59.1%). Fifty-seven per cent had erectile dysfunction (ED), while penile gangrene with autoamputation was observed in one patient (1.6%). Sixty-six per cent and 62% of patients who presented within < 36 h and 36-72 h, respectively, experienced normal erection at 6 months after surgery. Erectile function got progressively worse after 72 h, with all patients with ischemic priapism lasting more than 1 week developing ED. There was no statistically significant relationship between the variants of SCD and the risk of ED in patients who presented within 72 h.

Conclusion: The incidence of ischemic priapism was high, with sickle cell disease being the most common cause. The risk of ED was significantly worse after 72 h. The aetiology of priapism did not significantly influence the risk of ED.