Resume
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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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