[Sickle cell priapism. Therapeutic considerations in the light of 23 cases (author's transl)].

In Zaire, homozygote sickle cell disease affects 2% of the population and the heterozygote form 1 subject in 10. In that country, this disorder is the most common cause of priapism. The authors report 23 cases of sickle cell priapism seen over a period of 15 years : 14 cases of homozygote sickel disease and 9 cases of heterozygote sickle disease. Since 1972, all cases of priapism in homozygote sickle disease have been treated with transfusions of concentrated erythrocytes and of hyperosmolar sodium lactate (M6). In heterozygotes, the preferred treatment remains spheno-cavernous anastomosis, which does not cause impotence. In 12 homozygote cases treated by transfusion and alkalinisation, there was only one failure and 11 successes despite the long period between the onset of priapism and the start of treatment (69 hours on average). Despite the long duration of these cases of priaspism, almost all the patients retained an intact virility.