Background: Stuttering priapism is recurrent, self-limited episodes of sustained penile erection and is common in patients with sickle cell disease (SCD). Prevention of stuttering priapism is important to avoid progression to episodes of ischemic priapism which can cause erectile dysfunction. Priapism has been shown to be associated with increased nocturnal hypoxemia in patients with SCD.
Case description: A 43-year-old male with nocturnal episodes of stuttering priapism that was refractory to treatment with multiple medications was found to have obstructive sleep apnea (OSA). Following treatment of this condition with a continuous positive airway pressure (CPAP), the patient had immediate symptom relief and has had three months without an episode of priapism.
Conclusions: OSA should be considered as an underlying cause of nocturnal stuttering priapism in patients with SCD, particularly in patients who present with stuttering priapism later in life or patients who present strictly with nocturnal episodes. Appropriate management of OSA can significantly decrease the incidence of stuttering priapism in patients with SCD.
Keywords: Priapism; case report; obstructive sleep apnea (OSA); sickle cell disease (SCD); stuttering priapism.
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