Sexual health outcomes improvement in sickle cell disease: a matter of health policy?

摘要

INTRODUCTION: Ischemic priapism is a true male sexual dysfunction, consisting of uncontrollable, prolonged, and often painful erections of the penis. A commonly observed outcome, as a result of erectile tissue damage and fibrosis in this setting, is the complete loss of natural erectile ability. Males with sickle cell disease (SCD) are commonly affected. Given the adverse health consequences of this condition coupled with its specific population extent, health policy considerations are warranted. AIM: This article aimed to study circumstances surrounding priapism associated with SCD for the purpose of pushing forward health policy objectives that improve sexual health-related outcomes. METHODS: Medline searches through July 2010 were conducted using the following terms: priapism, sickle cell disease, epidemiology, public health, health economics, and health policy. MAIN OUTCOME MEASURE: Expert opinion was based on review of the medical literature related to this subject matter. RESULTS: The literature search affirmed that SCD-associated priapism threatens sexual health and also exerts a greatly negative impact on the physical and mental health of affected individuals. Various socioeconomic, behavioral, and cultural factors in the SCD population bearing negatively on sexual health outcomes were delineated. Deficiencies in several aspects of medical services for patients with SCD including scientific research funding support, which evoke an element of ethnic healthcare disparities, were further delineated. CONCLUSIONS: SCD-associated priapism is a medical condition of societal health significance, which can and should be addressed through comprehensive healthcare programmatic efforts. These efforts comprise advancement of educational and clinical training programs, support of interdisciplinary healthcare delivery services, diffusion of clinical advances, enactment of guidelines for effective clinical management, and resource allocation for enabling scientific advancements.