Prevalence and clinical determinants of priapism among male children with sickle cell disease seen at University of Benin Teaching Hospital, Benin City

Background Priapism is a serious urological complication of sickle cell disease (SCD) that may result in permanent erectile dysfunction if not promptly treated. Although it often begins in childhood or adolescence, paediatric data in Nigeria remain limited. Objective To determine the prevalence, clinical characteristics, and determinants of priapism among male children with SCD attending the University of Benin Teaching Hospital (UBTH), Benin City. Methods A hospital-based cross-sectional study was conducted between July and September 2025 among 120 male children aged 1–18 years with confirmed SCD. Eligible participants were consecutively recruited during routine clinic visits. Sociodemographic, clinical, haemoglobin phenotype, and haematologic data were obtained using structured questionnaires and medical record review. Anaemia severity was classified according to World Health Organization criteria. Associations were assessed using Chi-square tests, independent t-tests, and multivariable logistic regression. Statistical significance was set at p < 0.05. Results Sixteen participants had experienced priapism, giving a prevalence of 13.3% (95% CI: 8.3–20.6%). Most episodes occurred in the early morning (75%), and all episodes lasted ≥ 4 hours, with 87.5% persisting between 4 and 11 hours. On multivariable analysis, age ≥ 10 years (adjusted OR [aOR] = 3.98; 95% CI: 1.01–15.72; p = 0.048) and severe anaemia (aOR = 4.52; 95% CI: 1.38–14.81; p = 0.012) were independent predictors of priapism. Hydroxyurea use demonstrated a non-significant protective trend (aOR = 0.34; 95% CI: 0.10–1.12; p = 0.076). Conclusion Priapism affects approximately one in eight male children with SCD at UBTH. Adolescents and children with severe anaemia appear to be at increased risk. The finding that all reported episodes lasted ≥ 4 hours underscores the burden of ischemic priapism in this cohort. Routine counselling, early identification of high-risk patients, and strengthened adherence to guideline-based acute management may help reduce long-term complications.