Treatments for long-lasting and painful erection of the penis in boys and men with sickle cell disease

Priapism (the prolonged painful erection of the penis) is common in males with sickle cell disease (SCD). The length of time priapism lasts differs for different types and so does the medical treatment for it. Self-management approaches may be helpful. We looked for randomised controlled trials of different treatments to find the best option. We found one study set in Jamaica in 1985 with 11 people. In the study, stilboestrol was compared to placebo. The study only reports one of the outcomes from the review, how often stuttering priapism occurs. There is no difference between treatment groups for this outcome. Due to lack of evidence, we are not able to conclude the best treatment of priapism in SCD. Alpha agonists have become the treatment of choice for acute fulminant priapism and to prevent stuttering priapism. However, this is not supported by a randomised controlled trial. More research is needed. One trial is under way in the UK at this moment in time.