Men with sickle cell disease, a blood disorder, are more likely to develop erectile dysfunction (ED) as a result of “minor” instances of recurrent ischemic priapism (RIP), according to researchers from the Johns Hopkins University.
Priapism refers to an erection that lasts for several hours, but is not the result of sexual stimulation. When a man has ischemic priapism, blood becomes trapped in the penis and cannot flow out. Ischemic priapism is a medical emergency, and it can lead to tissue damage and ED, if left treated for 24 hours or longer.
RIP (also called stuttering priapism) occurs when there are repeated episodes of ischemic priapism over time. Often, these episodes are shorter, lasting under four hours. Many men with sickle cell disease experience RIP resulting in ED, even though the durations of priapism are shorter. The goal of this study was to learn more about ED and RIP, comparing men with sickle cell disease to men without this condition.
Using the International Index of Erectile Dysfunction (IIEF) or clinical evaluation, the researchers assessed the erectile function of 59 patients. Forty of the men (mean age 28.2 years) had sickle cell disease; nineteen (mean age 32.6 years) did not. The participants also answered questions about their priapism history.
For the analysis, the researchers defined three categories of RIP. “Very minor” RIP episodes lasted two hours or less. “Minor” RIP instances lasted for two to five hours. “Major” occurrences were longer than five hours.
On average, men with sickle cell disease started experiencing RIP around age 20. For men without sickle cell disease, the average onset age was about ten years later.
Thirty-nine percent of all participants were diagnosed with ED. However, ED rates for men with sickle cell disease were two times higher than those without.
After accounting for factors such as episode duration and frequency, the men with sickle cell disease were almost five times as likely to develop ED compared to the other men. They were also more likely to have ED during episodes of “very minor” RIP.
“In this study, we confirmed RIP to be a risk factor for ED with a higher prevalence rate of ED among [sickle cell disease] compared with non-[sickle cell disease] patients,” the authors noted.
“Patients with [sickle cell disease] may have an increased susceptibility to the reversible ischemic tissue injury associated with RIP episodes, or perhaps over time, these episodes have a cumulative effect in producing cavernosal damage independent of major episodes,” they added.
The study was first published online in January in The Journal of Sexual Medicine.
The Journal of Sexual Medicine
Anele, Uzoma A., MD and Arthur L. Burnett MD, MBA
“Erectile Dysfunction after Sickle Cell Disease–Associated Recurrent Ischemic Priapism: Profile and Risk Factors”
(Full-text. First published online: January 9, 2015)
Sexual Medicine Society of North America