KNOWLEDGE, EXPERIENCES AND COPING MECHANISMS FOR PRIAPISM AMONG PERSONS WITH SICKLE CELL DISEASE IN IBADAN, NIGERIA

Abstract

Priapism is a prolonged, painful penile erection and constitutes a reproductive health challenge among male Persons with Sickle Cell Disease (PWSCD). Erectile Dysfunction (ED) may result when treatment of priapism is delayed. Most studies in Nigeria have focused on female reproductive health challenge of PWSCD. However, knowledge, experiences and coping mechanisms for priapism have not been fully investigated. This study was therefore designed to investigate the knowledge, experiences and coping mechanisms for priapism among PWSCD in lbadan. The study was descriptive cross-sectional in design and purposive sampling technique was used to select 95 consenting PWSCD attending two of the three haematology clinics in Ibadan for interview. A semi-structured, interviewer-administered questionnaire was used to elicit information on respondents' socio-demographic characteristics, knowledge of priapism, coping mechanisms and sexual and psycho social health experiences. Furthermore, In-Depth Interviews (IDI) were conducted with the four persons who underwent surgical management of priapism. Knowledge of priapism was measured on a 30-point scale with scores of ≤10, >10-20; and >20 categorised as poor, fair and good respectively. Psychosocial Health Experiences (PHEs) were measured on an 8-point scale with scores of ≤4 and >4 categorised as moderate and severe PHEs of priapism while the Sexual Health Experiences (SHEs) including total ED, mild ED, apathy for sexual intercourse and sexual dissatisfaction were recorded. Coping mechanisms for priapism were grouped into Medical Coping Mechanisms (MCMs) and Psycho social Coping Mechanisms (PCMs). Quantitative data were analysed using descriptive statistics and Chi-square and Fishers' Exact test at p=0.05 while qualitative data were analysed thematically. Respondents' age was 23.6±8.8 years and 57.6% completed at least secondary education. Knowledge score was 17.0±4.8 and majority (69.5%) had fair knowledge of priapism. Thirty-nine respondents (41.1%) reported having experienced priapism. Among thirty-nine Respondents Reporting Priapism (RRP), (64.2%) reported different SHEs such as total ED (10.3%), mild ED (23.1%), apathy for sexual intercourse (23.1%) and sexual dissatisfaction (7.7%). There were no reports of SHEs among 15(35.8%) single/sexually inactive RRP. Majority of RRP (92.3%) developed moderate PHEs. Fear of re-occurrence of priapism (56.4%) and sleeplessness (43.6%) were the most reported PHEs among RRP. Cold shower (46.2%), oral hydration (38.5%) and mild exercise (35.9%) were the most used MCMs while spiritual intervention (59.0%), and being in intimate relationships (71.8%) accounted for most frequent PCMs. There was no significant association between age and knowledge of priapism. However, fair knowledge of priapism was highest among respondents aged 18-22. There was also no significant association between respondents' education and knowledge of priapism. However, fair knowledge of priapism was however highest among respondents at the secondary level of education. All four IDI discussants reported different types of ED arising from delayed surgical management of priapism and expressed desire for better post-surgical management outcomes. Knowledge of priapism among male persons with sickle cell disease was fair. Psychosociai therapy through appropriate health education, counseling and social support may help improve the knowledge of priapism among people with sickle cell disease and assist individuals with priapism to cope better.