EVALUATION OF ERECTILE FUNCTION IN MEN WITH SICKLE-CELL DISEASE

Objectives. To evaluate and characterize erectile manifestations assoc iated with sickle cell disease using nocturnal penile tumescence testi ng with polysomnography (NPT/PSG) and magnetic resonance imaging (MRI) of the penis. Methods. Six variably potent men with sickle cell disea se, of whom 5 reported a history of priapism, underwent comprehensive evaluations of erectile function. Evaluations involved a medical histo ry and physical examination with completion of priapism and sexual fun ction questionnaires, followed by NPT/PSG and MRI of the penis. Result s. Many different erectile abnormalities were identified in this group using NPT/PSG, although nocturnal erection durations as well as detum escence times were uniformly prolonged. Various axial rigidity measure ments were obtained, which correlated fairly well with individual repo rts of erectile function. MRI findings ranged from normal corporeal an atomy to corporeal destruction with intracorporeal fibrosis and hemosi derin deposition. Conclusions. In sickle cell disease, the erectile dy sfunction that commonly occurs may be markedly different among men wit h this disease and may not always be predicted on the basis of clinica l history of priapism. Generally, clinical assessments of erectile fun ction may be derived from clinical histories and physical examinations . NPT/PSG and MRI of the penis are in accord with these assessments, o bviating their routine use, although they may be valuable management a djuncts in certain situations.