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Priapism in Children - Abstract

Ali Ghribi, Manef Gasmi, Mourad Hamzaoui



Introduction: Priapism is persistent penile erection that is unrelated to sexual stimulation. Low-flow type is a urological emergency. The aim of this study is to illustrate our personal experience concerning the diagnostic and therapeutic management of priapism in children.

Patients and methods: A retrospective study was conducted involving 6 patients with priapism managed at our department, over a 20-year period, going from 1992 through 2012. Among them, 5 were because of sickle cell disease and 1 was of idiopathic origin in newborn.

Results: The study involved a 14-days-old neonate and 5 children whose ages ranged from 9 to 13 years. Mean duration of symptoms was 19.6 hours. The priapism was associated with confirmed sickle cell disease (SCD) and with newly diagnosed SCD in two others. It was of idiopathic origin in the newborn. The neonate was kept under observation and priapism disappeared after 18 hours without recurrence. In the older children, initial management was similar to that of other sickle cell crises (hyperhydration, oxygen, and analgesia). Because of the long duration of the priapism, emergency surgery was indicated under general anaesthesia. Successful detumescence was achieved after corporal aspiration in 4 patients. Caverno-glandular shunting, indicated after failure of corporal aspiration in one case. After surgery, spontaneous transient erection was self-reported by 4 patients without recurrence of priapism. One child presented after 6 months recurrence treated conservatively.

Conclusion: The first step of management of priapism is to distinguish ischemic from nonischemic type. Sickle cell disease is the commonest cause of ischemic priapism. Corporeal aspiration and modified Winter’s shunt were successful alternatives for patients with low-flow priapism. Management of idiopathic priapism in the newborn by observation alone seems to be safe. A long-term follow-up is necessary to assess erectile function.

Keywords: priapism, sickle cell disease, children, corporal aspiration



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