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

Background Few patients with priapism require inpatient management unless they are refractory to intracavernosal therapy. Their risk factors and outcomes are poorly characterized. Methods This is a retrospective analysis of the Nationwide Inpatient Sample (19982006). Priapism patients were identified and analyzed over time by age, race, sickle-cell disease diagnosis, drug abuse, and penile operations. Results A 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%. Conclusions Inpatient 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.