Access of men with sickle cell disease and priapism in emergency services

Abstract

BACKGROUND AND OBJECTIVES: Priapism is one of the complications of sickle cell disease characterized by a persistent and painful erection, which can lead to erectile dysfunction and sexual impotence. The objective of this study was to understand how men with sickle cell disease and priapism access emergency care. METHODS: A qualitative study conducted in a reference healthcare unit to people with sickle cell disease in the second largest city in Bahia. Seven adult men with sickle cell disease who had experienced priapism participated in the study. The data were collected by semi-structured interview and thematic story designs and submitted to content analysis. RESULTS: Priapism is seen as a lack of genital health. Participants use strategies to manage it at home to avoid embarrassment, which ends up in cocooning. Access to emergency services is motivated by persistent and relentless pain; and limited by the fear of priapism being mistaken for sexual deviance, lack of knowledge about the complication as a urologic emergency and financial shortfall, which confers a worse prognosis about erectile function. Men are embarrassed and discriminated by healthcare and support professionals, which discourages them from accessing these services in the future. CONCLUSION: This study emphasizes the importance of early diagnosis of sickle cell disease, the orientation of family members Access of men with sickle cell disease and priapism in emergency services Acesso de homens com doença falciforme e priapismo nos serviços de emergência

Why does your pain never get better? Stigma and coping mechanism in people with sickle cell disease

“…Men with SCD suffer discrimination and prejudice when they suffer a priapism crisis, one of its complications. Many blame the patient for confusing it with penile erection related to sexual desire, so they treat him with disrespect, labeling, and excessive exposure, generating embarrassment and shame (22,34) .…”

Psicologia Jurídica: Análise Epistemológica

“…Além disso as narrativas da doença elaboradas por homens com DF evidenciam constrangimentos e discriminações sofridas nas unidades de emergências durante os eventos de priapismo quando são motivo de "piadas", curiosidade de leigos e profissionais e são rotulados pejorativamente de desviados sexuais (MAIA et al, 2019).…”

“…Estudo evidenciou que a vergonha antecipada desencoraja os homens a acessar serviços especializados, o que é imprescindível desde as primeiras 2 horas do evento para resolução do priapismo e redução de complicações (MAIA et al, 2019). Em geral procuram primeiro cansar fisicamente o corpo submetendo-se a exercícios extenuantes, ou a banhos quentes de forma prolongada almejando o relaxamento do pênis.…”

Traducão E Adaptação Transcultural Da Sickle Cell Disease Health-Related Stigma Scale Para O Contexto Brasileiro

“…As complicações da DF atingem todos os sistemas orgânicos. As alterações visíveis que produzem, conferem ao adoecido uma aparência frágil (2) . Além disso, as constantes crises álgicas, anemia grave e priapismo levam à busca frequente por serviços de emergência.…”

“…Ao serem julgadas pela aparência, as pessoas com DF são constantemente confundidas com portadores de doenças infectocontagiosas. Ao demandarem analgésicos durante as crises álgicas, são identificados como drogodependentes, o que os conduz a processos de estigmatização (1)(2)(3)(4) .…”