Potential risks of chronic sildenafil use for priapism in sickle cell disease.

INTRODUCTION: Priapism is a common concern in sickle cell disease. With a high frequency of recurrences and serious long-term sequela, a preventative, rather than traditionally reactive approach, needs to be taken in these patients. Reports have shown successful use of sildenafil as a prophylactic treatment but have failed to address adverse outcomes, including vasoocclusive pain crises, of chronic sildenafil therapy in sickle cell patients.

AIMS: We wish to draw attention to the potential adverse outcomes of this therapy on the overall state of the patient's disease for consideration in future studies.

METHODS: We used sildenafil in a patient suffering from almost daily attacks of priapism.

RESULTS: Sildenafil was successful in decreasing the frequency of priapism; however, our patient experienced an increased frequency of vasoocclusive crises, something not previously addressed.

CONCLUSION: Future studies of sildenafil use in sickle cell disease need to assess the global state of the disease, not just the frequency of priapism.