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Surgical management of priapism in children with sickle cell anemia
Insights
Percutaneous fistula creation is a successful treatment for priapism in children with sickle cell disease. This surgical approach offers a viable option for patients previously excluded from such interventions.
Area of Science:
- Urology
- Hematology
- Pediatrics
Background:
- Priapism affects 2-5% of sickle cell disease patients.
- Shunting procedures for priapism are often avoided in sickle cell anemia patients due to reported failures.
- This avoidance may have limited surgical benefits for this population.
Purpose of the Study:
- To evaluate the efficacy of percutaneous fistula creation in managing priapism in children with sickle cell anemia.
- To present a treatment plan for this specific patient group.
Main Methods:
- Successful management of 5 children with sickle cell anemia and priapism using percutaneous fistula creation between the glans penis and corpora cavernosa.
- Implementation of a treatment plan involving early shunting if nonoperative treatments fail.
Main Results:
- Successful surgical management without complications in all 5 pediatric patients.
- Demonstrated the feasibility and safety of the shunting procedure in this cohort.
Conclusions:
- Percutaneous fistula creation is a safe and effective treatment for priapism in pediatric sickle cell anemia patients.
- This surgical option should be considered for sickle cell patients experiencing priapism, challenging previous exclusions.
Abstract:
Priapism has been reported to occur in 2 to 5 per cent of patients with sickle cell disease. Recently, creation of a percutaneous fistula between the glans penis and the corpora cavernosa has been applied widely in the management of patients with priapism, except in those cases of sickle cell anemia. Reported failures of such shunting procedures in the sickle cell patient has perhaps unduly denied surgical benefits to that population. We have managed successfully 5 such children with sickle cell anemia and priapism without complications by creation of a fistula between the glans penis and the corpora cavernosa. Our treatment plan is presented, which includes early shunting should initial nonoperative treatment fail.