Penile Scintigraphy for Priapism in Sickle Cell Disease

Penile scintigraphy with [ 99m Tc]pertechnetate/ 99m Tc-RBCS was performed in patients with sickle cell disease patients who had priapism to assess the role of this imaging procedure in directing the clinical management of these patients. Methods : Fifteen studies were performed in 13 patients who were treated according to a protocol not dependent on the imaging results. The scintigraphic findings of penile vascular perfusion (stagnant or nonstagnant pattems) were collated retrospectively with the form of treatment needed for relief of the condition. Results : Four of five patients with the nonstagnant perfusion pattem responded to analgesics and intravenous hydration. Four of eight patients with the stagnant pattem did not require any aggressive interventions such as corporeal aspiration/irrigation, intracorporeal epinephrine or glans-cavemosa shunt. Conclusion : Whereas the nonstagnant scintigraphic finding appeared to be a favorable indicator for conservative treatment, the stagnant finding was apparently noncontributory. In addition, no correlation was found between these two types of scintigraphic pattems and the sub sequent sexual potency of these patients.