Priapism, erections occurring unwillfully in a prolonged manner, is generally viewed to be an uncommon phenomenon of minor public health concern. However, in some regions of the world it constitutes a clinical disorder of considerable magnitude. In Mediterranean and sub-Saharan African countries, for instance, priapism occurs frequently as a complication of sickle cell disease that is prevalent in these geographic regions. Just for perspective, approximately 100,000 individuals in the United States have sickle cell disease, whereas in Nigeria this disease occurs in 150,000 births per year.

In Nigeria, additional factors besides its high frequency compound the adversity of priapism. It has been observed that young men and boys in this country with this disorder regularly do not receive prompt and effective treatment for priapism, resulting in complete erection loss and major penile injury at early stages of life. Medical officers commonly lack awareness of the immediacy and gravity of an acute priapism episode, and many are not trained to initiate proper care and make referrals to a urologist. Clinical presentations of acute priapism episodes to medical centers are also usually delayed, owing substantially to inadequate counseling of patients with sickle cell disease regarding the significance of this disorder.

The atrocity of priapism signals a call to action. Intent on addressing this problem, an international health provider and clinical research program was organized centering on Kano, Nigeria, notable as the state having the highest rate of sickle cell disease per capita in the world. I have been able to collaborate in this humanitarian team effort, which combines medical officers and researchers in hematology and urology from local institutions, including Aminu Kano Teaching Hospital, Bayero University Kano, and Kano State Hospitals, and from 2 academic sites in the United States. Over the past decade, we have performed assorted health services projects in conjunction with clinical trials purposed to improve the management of complications of sickle cell disease. Most recently, we conducted a teaching and training exercise on priapism management in the form of a full-day interactive workshop.

Figure 1. A precourse welcome reception attended by surgical administrators and staff of the Aminu Kano Teaching Hospital.

Figure 2. Lecture session in the diagnosis and management of priapism.

Figure 3. Hands-on training by a course attendee in performing penile aspiration using a hydrogel penis simulation model of ischemic priapism.

The International Workshop in the Management of Priapism was held in early July this year at Aminu Kano Teaching Hospital in Kano, Nigeria, with more than 150 medical officers attending from various parts of Kano and neighboring states (Figure 1). I served as the course director and faculty lecturer. The course comprised a series of lectures on the disease profile of sickle cell disease–associated priapism and on its diagnosis and management, which was followed by a hands-on session involving surgical procedures for the acute management of priapism (Figure 2). The latter consisted of interactive training in such procedures as penile aspiration and shunting, applying hydrogel penis simulation models of ischemic priapism (Figure 3). This event also included media presentations in the way of radio broadcasting about priapism as a health education and awareness campaign directed toward the general public and news reporting in print format.

Early reports indicate the workshop was successful.

As we conduct surveys assessing the impact of the workshop, it is hoped that the knowledge exchange will contribute toward improved management of priapism in Kano and possibly nearby regions of Africa. We anticipate carrying out more such workshops in the future.

Our outreach program in Kano has been very worthwhile thus far. It is hoped we will achieve improved outcomes for patients by advancing the management of sickle cell disease-related complications. I draw particular inspiration in this endeavor from my health care colleagues in Kano, who have demonstrated the greatest level of humanitarianism and commitment to their patients despite hardships they face with limited resources.