Potential risks of chronic sildenafil use for priapism in sickle cell disease

Priapism is a common concern in sickle cell disease. With a high frequency of recurrences and serious long-term sequela, a preventative, rather than traditionally reactive approach, needs to be taken in these patients. Reports have shown successful use of sildenafil as a prophylactic treatment but have failed to address adverse outcomes, including vasoocclusive pain crises, of chronic sildenafil therapy in sickle cell patients.

We wish to draw attention to the potential adverse outcomes of this therapy on the overall state of the patient's disease for consideration in future studies.

We used sildenafil in a patient suffering from almost daily attacks of priapism.

Sildenafil was successful in decreasing the frequency of priapism; however, our patient experienced an increased frequency of vasoocclusive crises, something not previously addressed.

Future studies of sildenafil use in sickle cell disease need to assess the global state of the disease, not just the frequency of priapism.