Priapism in the United States: the changing role of sickle cell disease

BackgroundFew patients with priapism require inpatient management unless they are refractory to intracavernosal therapy. Their risk factors and outcomes are poorly characterized.MethodsThis is a retrospective analysis of the Nationwide Inpatient Sample (1998–2006). Priapism patients were identified and analyzed over time by age, race, sickle-cell disease diagnosis, drug abuse, and penile operations.ResultsA total of 4,237 hospitalizations for priapism were identified (30% white, 61.1% black, and 6.3% Hispanics). There was an increasing incidence of priapism over time, concentrated in the middle-age group. There were 1,776 patients (41.9%) with diagnoses of sickle-cell disease, with decreasing proportions over time. Drug abuse was reported in 7.9%.ConclusionsInpatient diagnoses of priapism are increasing over time with relatively constant numbers of sickle-cell disease patients, suggesting rising nonhematologic causes of priapism. One theory is that increasing use of aggressive therapies for erectile dysfunction might play a role, especially when combined with drug abuse.