A 20-year-old man with sickle cell disease (HbSS) presents with a painful, rigid erection lasting 5 hours. What is the recommended initial management?
- A Hydration, analgesia, and oral or intranasal sympathomimetic agents ✓
- B Immediate surgical shunting
- C Ice packs to the perineum and bed rest
- D Exchange transfusion alone
Correct answer: A. Hydration, analgesia, and oral or intranasal sympathomimetic agents
Explanation
Acute priapism in sickle cell disease is managed initially with hydration, analgesia, and sympathomimetics (etilefrine or phenylephrine aspiration and irrigation if refractory). Early intervention within 4-6 hours reduces impotence risk. Surgery is reserved for refractory cases lasting over 24 hours. Exchange transfusion is not first-line. Ice packs are not recommended.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.