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The use of diethylstilboestrol in the treatment of priapism in sickle cell disease patients- Two case reports and a review of the literature

Priapism is a painful and persistent erection usually unassociated with sexual stimulation. The prevalence of priapism in patients with sickle cell disease is 2% to 11%. Retrospective studies indicatethat 30% to 45% have experienced priapism on one or more occasions. Prolonged priapism is a urologic emergency requiring urgent intervention to avoid irreversible penile fibrosis and impotence.Several therapeutic procedures, including hydration, analgesics, erythrocytapheresis, vasodilators, hydroxiurea, hormones (diethylstilboestrol), aspiration of blood from thecorpora cavernosa and intrapenile injections of vasoactive drugs and surgical procedure (cavernosa-spongiosum shunt) have beenproposed for the treatment of priapism in sickle cell patients. The aim of this article is to describe two clinical cases of sickle cell disease patients with priapism who did not respond to the clinical and hemotherapeutic treatment but obtained complete resolution of the acute episodes taking diethylstilboestrol.

Priapism; diethylstilboestrol


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