Archive | 2019
Access of men with sickle cell disease and priapism in emergency services
Abstract
BACKGROUND AND OBJECTIVES: Priapism is one of the complications of sickle cell disease characterized by a persistent and painful erection, which can lead to erectile dysfunction and sexual impotence. The objective of this study was to understand how men with sickle cell disease and priapism access emergency care. METHODS: A qualitative study conducted in a reference healthcare unit to people with sickle cell disease in the second largest city in Bahia. Seven adult men with sickle cell disease who had experienced priapism participated in the study. The data were collected by semi-structured interview and thematic story designs and submitted to content analysis. RESULTS: Priapism is seen as a lack of genital health. Participants use strategies to manage it at home to avoid embarrassment, which ends up in cocooning. Access to emergency services is motivated by persistent and relentless pain; and limited by the fear of priapism being mistaken for sexual deviance, lack of knowledge about the complication as a urologic emergency and financial shortfall, which confers a worse prognosis about erectile function. Men are embarrassed and discriminated by healthcare and support professionals, which discourages them from accessing these services in the future. CONCLUSION: This study emphasizes the importance of early diagnosis of sickle cell disease, the orientation of family members Access of men with sickle cell disease and priapism in emergency services Acesso de homens com doença falciforme e priapismo nos serviços de emergência Heros Aureliano Antunes da Silva Maia1, Mateus Andrade Alvaia1, Jayanne Moreira Carneiro2, Aline Silva Gomes Xavier2, José de Bessa Júnior2, Evanilda Souza de Santana Carvalho2 Heros Aureliano Antunes da Silva Maia \ue9d9https://orcid.org/0000-0003-4751-5987; Mateus Andrade Alvaia \ue9d9https://orcid.org/0000-0003-0075-4753; Jayanne Moreira Carneiro \ue9d9https://orcid.org/0000-0003-3961-7959; Aline Silva Gomes Xavier \ue9d9https://orcid.org/0000-0002-3012-6849; José de Bessa Júnior \ue9d9https://orcid.org/0000-0003-4833-4889; Evanilda Souza de Santana Carvalho3 \ue9d9https://orcid.org/0000-0003-4564-0768. 1. Universidade Estadual de Feira de Santana, Departamento de Saúde, Curso de Medicina, Feira de Santana, BA, Brasil. 2. Universidade Estadual de Feira de Santana, Departamento de Saúde, Programa de PósGraduação em Saúde Coletiva, Feira de Santana, BA, Brasil. Submitted in July 20, 2018. Accepted for publication in September 17, 2018. Conflict of interests: none – Sponsoring sources: Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB). Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Correspondence to: Avenida Transnordestina, s/n Novo Horizonte 44036-900 Feira de Santana, BA, Brasil. E-mail: [email protected] © Sociedade Brasileira para o Estudo da Dor and the need for healthcare professionals to educate young boys and men with sickle cell disease and their caregivers about priapism in advance to allow adequate self-care and prevent complications.