Priapism is Associated with Sleep Hypoxemia in Sickle Cell Disease

• Published in: The Journal of urology Vol. 188; no. 4; pp. 1245 - 1251
• Main Authors: Roizenblatt, Marina, Figueiredo, Maria Stella, Cançado, Rodolfo Delfini, Pollack-Filho, Frederico, de Almeida Santos Arruda, Martha Mariana, Vicari, Perla, Sato, João Ricardo, Tufik, Sergio, Roizenblatt, Suely
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2012; Elsevier
• Subjects: Adolescent; Adult; anemia, sickle cell; Anemia, Sickle Cell - complications; anoxia; Biological and medical sciences; Case-Control Studies; Gynecology. Andrology. Obstetrics; Humans; Hypoxia - complications; Male; Male genital diseases; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Non tumoral diseases; penis; priapism; Priapism - etiology; sleep; Sleep Apnea Syndromes - complications; Urology; Young Adult; S3; AHI; oxyhemoglobin saturation; T 90; rapid eye movement; SaO 2; sickle cell disease; sleep; PLM; SDB; anemia, sickle cell; RLS; penis; total sleep time; anoxia; restless legs syndrome; periodic limb movement; apnea-hypopnea index; priapism; time with SaO 2 less than 90; TST; SCD; sleep disordered breathing; sleep stage 3; sleep stage 1; sleep stage 2; REM; S1; S2; T90; SaO2; Hemoglobinopathy; Nephrology; Oxygen; Anoxia; Sickle cell anemia; Erection disorders; Hemopathy; Male genital system; Urology; anemia; Genetic disease; Priapism; Hemolytic anemia; Hypoxemia; Sleep; Penis; sickle cell; Sleep wake cycle; Male genital diseases
• ISSN: 0022-5347; 1527-3792
• DOI: 10.1016/j.juro.2012.06.015

Purpose We assessed penile rigidity during sleep and the relationship of sleep abnormalities with priapism in adults with sickle cell disease. Materials and Methods This was a case-control study of 18 patients with sickle cell disease and a history of priapism during the previous year, and 16 controls with sickle cell disease. Participants underwent overnight polysomnography and RigiScan® Plus recording to detect penile rigidity oscillations. Results The priapism group (cases) showed a higher apnea-hypopnea index and oxyhemoglobin desaturation parameters than controls. A lower positive correlation between the apnea-hypopnea index and oxyhemoglobin desaturation time was observed in cases than in controls (Spearman coefficient ρ = 0.49, p = 0.05 vs ρ = 0.76, p <0.01), suggesting that desaturation events occurred independently of apnea. Two controls and 14 cases had a total sleep time that was greater than 10% with oxyhemoglobin saturation less than 90% but without CO2 retention. Penile rigidity events were observed during rapid eye movement sleep and during stage 2 of nonrapid eye movement sleep, particularly in cases. The duration of penile rigidity events concomitant to respiratory events was higher in cases than in controls. Regression analysis revealed that the periodic limb movement and desaturation indexes were associated with priapism after adjusting for rapid eye movement sleep and lung involvement. Finally, oxyhemoglobin saturation less than 90% was associated with priapism after adjusting for lung involvement, hyperhemolysis and the apnea-hypopnea index. Conclusions Oxyhemoglobin desaturation during sleep was associated with priapism history. It may underlie the distribution pattern of penile rigidity events during sleep in these patients.