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Genitourinary complications of sickle cell disease
D Bruno1, D R Wigfall, S A Zimmerman
1Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
The Journal of Urology
|August 8, 2001
Summary
Sickle cell disease (SCD) can cause serious genitourinary issues like kidney failure and priapism. Increased awareness and new treatments like hydroxyurea may prevent these severe complications.
Area of Science:
- Genitourinary Medicine
- Hematology
- Oncology
Background:
- Sickle cell disease (SCD) is characterized by microvascular occlusion affecting multiple organ systems.
- The genitourinary tract is frequently impacted by SCD, leading to hematuria, urinary tract infections, and priapism.
- Serious genitourinary sequelae of SCD have been increasingly identified over time.
Purpose of the Study:
- To review the molecular biology, pathophysiology, and natural history of sickle cell disease.
- To highlight the spectrum of genitourinary complications associated with sickle cell disease.
- To discuss advancements in diagnosis, management, and potential preventative therapies for SCD-related genitourinary issues.
Main Methods:
- Computerized MEDLINE search (1965-present) and bibliographic review.
- Analysis of cross-references for meaningful findings and case reports.
- Literature review focusing on genitourinary manifestations of sickle cell disease.
Main Results:
- Significant advancements in SCD diagnosis and management have increased patient life expectancy.
- Genitourinary complications include altered renal function (mild to complete loss), increased risk of urinary tract infections, and priapism.
- Renal medullary carcinoma, a lethal tumor, is almost exclusively found in patients with sickle cell trait.
Conclusions:
- Increased awareness of genitourinary complications can prevent end-stage renal disease and impotence.
- Emerging therapies, such as hydroxyurea, show promise in preventing future SCD-related genitourinary complications.
- Early recognition and management are crucial for improving outcomes in sickle cell disease patients.