The physical, social and psychological impact of priapism on adult males with sickle cell disorder.

Priapism is defined as prolonged and painful penile erection that does not subside on orgasm. It is considered to be a urological emergency. However, patients do not always seek prompt medical help. The incidence of priapism is increased by sickle cell disease, where it is a complication of the characteristic sickling of the red blood cells. Little is known about the psychological or social implications of this complication or the strategies that sickle cell patients use to manage it. A qualitative study was carried out in order to investigate these topics. Semi-structured interviews were carried out with adult male patients of the Sickle Cell and Thalassaemia Centre in Birmingham in the UK who experienced priapism. These were subsequently analysed using grounded theory. Ten themes were elicited: first occurrence of priapism, pain, precipitants, emotional consequences, self-management, experience of hospital, impact on work and social life, impact on sexual relationships, erectile dysfunction, and disclosure. The dominant experiences were ones of despair, embarrassment, and isolation. Participants described finding it difficult to disclose priapism, with the result that it was often unreported until late in its course. Attempts to manage priapism at home varied, with there being little consensus on their efficacy. The results are discussed with respect to the healthcare services that cater for these patients.