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Prise en Charge du Priapisme Chez L’enfant, au Chu de Treichville

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Objectif

Le but de cette étude est d’évaluer la prise en charge du priapisme dans notre service en vue de proposer une conduite á tenir á partir d’une revue de la littérature.

Patients et méthodes

Il s’agit d’une étude rétrospective portant sur 7 dossiers de patients suivis pour priapisme dans le service de chirurgie pédiatrique du CHU de Treichville, de Janvier 2006 á Octobre 2010. Nous avons analysé: l’âge, les antecedents, le délai de prise en charge, l’étiologie, les aspects cliniques, le traitement, et l’évolution.

Résultats

Il s’agissait de 7 enfants de race noire, de sexe masculin, âgés de 3 ans á 14 ans. Nous avons observé: un priapisme aigu chez 4 enfants (85.71%) drépanocytaires SSFA2, un priapisme intermittent chez 2 enfants hétérozygotes AS et 1 cas de priapisme intermittent idiopathique. Le priapisme aigu a été traité chirurgicalement par shunt caverno-balanique unilatérale sans excision d’albuginée selon le procédé de Falandry. Le priapisme intermittent a été traité par l’administration orale d’étiléfrine. Aprés la chirurgie, nous avons observé 3 bons résultats immédiats (75%) et 1 bon résultat 24 heures aprés. Aucune récidive ni aucun trouble de l’érection n’ont été observés aprés un recul moyen de 14 mois.

Conclusion

Le priapisme est une complication fréquente de la drépanocytose qui doit être recherchée et traitée de façon concomitante. Nous préconisons l’injection intracaverneuse précoce d’étiléfrine suivie, en cas d’échec, par la chirurgie selon la technique de Al-gorhab mod Falandry. Des études doivent être effectuées le résultat á long terme, de cette technique, sur la fonction érectile. L’accent doit être mis sur la sensibilisation a de prévenir la survenue d’une impuissance sexuelle irréversible.

Abstract

Objectives

The purpose of this study is to evaluate the management of priapism in our department to propose a management in agreement with literature review.

Patients and Methods

This is a retrospective study of 7 cases of patients treated for priapism in the pediatric surgery department of the University Hospital of Treichville, from January 2006 to October 2010. We analyzed: age, history, the period of treatment, etiology, clinical aspects, treatment, and evolution.

Results

There were 7 children, all black, male and their age ranged from 3 years to 14years. We observed: an acute priapism in 4 children (85.71%) with sickle cell disease (SCD) SSFA2, Intermittent priapism in 2 heterozygous AS children, and 1 intermittent idiopathic priapism. Acute priapism was treated surgically by unilateral cavernosa-glandular shunt without excision of albuginea by the method of Falandry. Intermittent priapism was treated by oral administration of etilefrine. After surgery, we noticed 3 immediate good results (75%) and a good result after 24 hours. No relapse and no erectile dysfunction were observed after 14mois mean follow-up.

Conclusion

Priapism is a common complication of sickle cell disease; which must be sought and treated concomitantly. We advocate early intracavernosal injection of etilefrine, followed if unsuccessful, with surgery using Al-gorhab procedure modi conducted to assess the long-term outcome of this technique on erectile function. The focus should be on raising awareness of risk of priapism in children with SCD, in order to prevent the occurrence of irreversible sexual impotence.

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Bibliographie

  1. Pryor J, Akkus E, Alter G, Jordan G, Lebret T, Levine L, et al. Priapism. J.Sex.Med. 2004;1(1):116–120.

    Article  PubMed  Google Scholar 

  2. Melman A, Serels S. Priapism. Int.J.Impot.Res. 2000; Oct;12 Suppl 4:S133–S139.

    Article  Google Scholar 

  3. Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, et al. American urological association guideline on the management of priapism. J.Urol. 2003; Oct;170(4 Pt 1):1318–1324.

    Article  PubMed  Google Scholar 

  4. Medina CA. Clitoral priapism: A rare condition presenting as a cause of vulvar pain. Obstet.Gynecol. 2002; Nov;100(5 Pt 2):1089–1091.

    Article  PubMed  Google Scholar 

  5. Nolan VG, Wyszynski DF, Farrer LA, Steinberg MH. Hemolysis-associated priapism in sickle cell disease. Blood. 2005; Nov 1;106(9):3264–3267.

    Article  Google Scholar 

  6. Colombani JF, Peluchon P, Elana G, Delatre P. Priapism in a sickle cell prepuberal child. Eur.J.Pediatr.Surg. 2000; Feb;10(1):68–71.

    Article  PubMed  CAS  Google Scholar 

  7. Labat F, Dubousset AM, Baujard C, Wasier AP, Benhamou D, Cucchiaro G. Epidural analgesia in a child with sickle cell disease complicated by acute abdominal pain and priapism. Br.J.Anaesth. 2001; Dec;87(6):935–936.

    Article  PubMed  CAS  Google Scholar 

  8. Babela JR, Nzingoula S, Senga P. Les crises vasoocclusives drepanocytaires chez l’enfant et l’adolescent a Brazzaville, Congo. Etude retrospective de 587 cas. [Sickle-cell crisis in the child and teenager in Brazzaville, Congo. A retrospective study of 587 cases]. Bull.Soc. Pathol.Exot. 2005; Dec;98(5):365–370.

    PubMed  Google Scholar 

  9. Inati A, Jradi O, Tarabay H, Moallem H, Rachkidi Y, El Accaoui R, et al. Sickle cell disease: The Lebanese experience. Int.J.Lab.Hematol. 2007;29(6):399–408.

    Article  PubMed  CAS  Google Scholar 

  10. Falandry L. Priapisme: Traitement et resultats. A propos d’une serie personnelle de 56 cas. [Priapism: Treatment and results. Personal series of 56 cases]. Prog.Urol. 1999; Jun;9(3):496–501.

    PubMed  CAS  Google Scholar 

  11. Badmus TA, Adediran IA, Adesunkanmi AR, Katung IA. Priapism in southwestern Nigeria. East Afr.Med.J. 2003; Oct;80(10):518–524.

    PubMed  CAS  Google Scholar 

  12. Adeyoju AB, Olujohungbe AB, Morris J, Yardumian A, Bareford D, Akenova A, et al. Priapism in sicklecell disease; Incidence, risk factors and complications - an international multicentre study. BJU Int. 2002; Dec;90(9):898–902.

    Article  PubMed  CAS  Google Scholar 

  13. Roupret M, Beley S, Traxer O, Kirsch Noir F, Jouannet P, Jardin A, et al. Prise en charge du priapisme chez les patients drepanocytaires [Management of priapism in patients with sickle-cell anaemia]. Prog.Urol. 2005; Jun;15(3):392,6; discussion 396–7.

    PubMed  Google Scholar 

  14. Gbadoé AD, Diagne I, Ilboudo A, Diop S, Géraldo A, Guédénon J, et al. Priapism in sickle cell anaemia in Senegal: Prevalence, attitudes and knowledge [Priapisme chez le drépanocytaire sénégalais: Prévalence, attitudes et connaissances]. Bull.Soc.Pathol.Exot. 2007;100(3):179–181.

    Google Scholar 

  15. Bennett N, Mulhall J. Sickle cell disease status and outcomes of African-American men presenting with priapism. J.Sex.Med. 2008;5(5):1244–1250.

    Article  PubMed  Google Scholar 

  16. De Jesus LE, Dekermacher S. Priapism in children: Review of pathophysiology and treatment. J.Pediatr. 2009;85(3):194–200.

    Google Scholar 

  17. Sandler G, Soundappan SSV, Cass D. Appendicitis and low-flow priapism in children. J.Pediatr.Surg. 2008;43(11):2091–2095.

    Article  PubMed  Google Scholar 

  18. Yuan J, Desouza R, Westney OL, Wang R. Insights of priapism mechanism and rationale treatment for recurrent priapism. Asian J.Androl. 2008;10(1):88–101.

    Article  PubMed  CAS  Google Scholar 

  19. Castagnetti M, Sainati L, Giona F, Varotto S, Carli M, Rigamonti W. Conservative management of priapism secondary to leukemia. Pediatr.Blood Cancer. 2008;51(3):420–423.

    Article  PubMed  Google Scholar 

  20. Gross EM, Levin PD, Landau EH. Post-splenectomy veno-occlusive priapism in a child with idiopathic thrombocytopenic purpura. Isr.Med.Assoc.J. 2002; Nov;4(11):1084–1085.

    PubMed  Google Scholar 

  21. Maples BL, Hagemann TM. Treatment of priapism in pediatric patients with sickle cell disease. Am.J.Health. Syst.Pharm. 2004; Feb 15;61(4):355–363.

    Google Scholar 

  22. Gbadoe AD, Atakouma Y, Kusiaku K, Assimadi JK. Management of sickle cell priapism with etilefrine. Arch.Dis.Child. 2001; Jul;85(1):52–53.

    Article  PubMed  CAS  Google Scholar 

  23. Gbadoe AD, Akakpo Vidah A, Pitche P, Assimadi JK. Priapisme drepanocytaire: Prise en charge par injections intracaverneuses d’etilefrine [Sickle cell disease priapism: Treatment with intracavernous injections of etilefrine]. Med.Trop.(Mars). 2000;60(1):53–56.

    CAS  Google Scholar 

  24. Slimen MH, Fakhfakh H, Gassara M, Kechaou S, Bahloul A, Mhiri MN. Venous priapism: Treatment and prognosis based on a series of 26 cases [Priapisme veineux: Traitement et pronostic fonctionnel. A propos de 26 cas]. Andrologie. 2008;18(4):264–273.

    Article  Google Scholar 

  25. Bachir D, Virag R, Lee K, Belloy M, de Montalembert M, Denis L, et al. Prevention and treatment of erectile disorders in sickle cell disease. Rev.Med.Interne. 1997;18(Suppl 1):46s–51s.

    Article  PubMed  Google Scholar 

  26. Hekal IA, Meuleman EJ. Idiopathic low-flow priapism in prepuberty: A case report and a review of literature. Advances in Urology. 2008:Art. no. 549861.

  27. Gbadoé AD, Géraldo A, Guédénon K, Ko K, Akpako P. Stuttering priapism in children with sickle cell anemia in Togo [Priapisme intermittent chronique chez l’enfant drépanocytaire homozygote au Togo]. Arch.Pediatr. 2007;14(7):861–863.

    Article  Google Scholar 

  28. McHardy P, McDonnell C, Lorenzo AJ, Salle JLP, Campbell FA. Management of priapism in a child with sickle cell anemia; Successful outcome using epidural analgesia. Can.J.Anesth. 2007;54(8):642–645.

    Article  PubMed  Google Scholar 

  29. Diagne I, Diagne Gueye ND, Signate Sy H, Camara B, Lopez Sall P, Diack Mbaye A, et al. Prise en charge de la drepanocytose chez l’enfant en Afrique: Experience de la cohorte de l’Hopital d’enfants Albert Royer de Dakar [Management of children with sickle cell disease in Africa: Experience in a cohort of children at the Royal Albert Hospital in Dakar]. Med.Trop.(Mars). 2003;63(4–5):513–520.

    CAS  Google Scholar 

  30. Raveenthiran V. A modi treatment of pediatric low-flow priapism. J.Pediatr.Surg. 2008;43(11):2082–2086.

    Article  PubMed  Google Scholar 

  31. Mitsingou JC, Goma P. Le traitement du priapisme par le shunt carverno-spongieux selon la technique de Al-Ghorab. A propos de 5 cas traités á la clinique chirurgicale des armées de Pointe-Noire (Congo) [Treatment of priapism by the caverno-glandular shunt with the technique of Al-Ghorab: About 5 cases treated at the clinique chirurgicale des armées, Pointe-Noire (Congo)]. Méd.Afr.Noire. 1994;41(1):66–67.

    Google Scholar 

  32. Muneer A, Minhas S, Arya M, Ralph DJ. Stuttering priapism - a review of the therapeutic options. Int.J.Clin. Pract. 2008;62(8):1265–1270.

    Article  PubMed  CAS  Google Scholar 

  33. Shah A, Parashar K, Chandran H. Paediatric priapism - treatment conundrum. Pediatr.Surg.Int. 2004;20(10):806–808.

    Article  Google Scholar 

  34. Gbadoe AD, Dogba A, Segbena AY, Nyadanu M, Atakouma Y, Kusiaku K, et al. Priapism in sickle cell anemia in Togo: Prevalence and knowledge of this complication. Hemoglobin. 2001; Nov;25(4):355–361.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Service de chirurgie pédiatrique du CHU de Treichville, Abidjan, Côte d’Ivoire

    K. R. Nandiolo-Anelone, S. R. Bankolé & M. L. Mobiot

  2. Service d’urologie du CHU de Bouaké, Bouaké, Côte d’Ivoire

    K. Djè

  3. 20 BP1069, Abidjan 20, Côte d’Ivoire

    K. R. Nandiolo-Anelone

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  1. K. R. Nandiolo-Anelone
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  2. K. Djè
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  3. S. R. Bankolé
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  4. M. L. Mobiot
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Correspondence to K. R. Nandiolo-Anelone.

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Nandiolo-Anelone, K.R., Djè, K., Bankolé, S.R. et al. Prise en Charge du Priapisme Chez L’enfant, au Chu de Treichville. Afr J Urol 17, 59–65 (2011). https://doi.org/10.1007/s12301-011-0012-4

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  • DOI: https://doi.org/10.1007/s12301-011-0012-4

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