Mels F van Driel1, Jack J Beck2, Henk W Elzevier2, Johannes H van der Hoeven3, J M Nijman4. 1. Department of Urology, University of Groningen, Groningen, the Netherlands;. Electronic address: m.f.van.driel@uro.umcg.nl. 2. Department of Urology, University of Leiden, Leiden, the Netherlands. 3. Department of Neurophysiology, University of Groningen, Groningen, the Netherlands. 4. Department of Urology, University of Groningen, Groningen, the Netherlands.
Abstract
INTRODUCTION: As specialists in male genital problems, urologists and sexologists will most likely to be involved in the treatment of males presenting with sleep-related painful erections (SRPEs). This means that this phenomenon needs to be recognized by urologists and sexologists, and that they should have knowledge of the current diagnostic and therapeutic approaches. Aim. To review the literature on SRPE and to find the best pharmacological treatment. Methods. Four personal clinical observations from two clinics and 29 other cases with SRPE found in PubMed were analyzed, especially regarding the results of pharmacological treatment. MAIN OUTCOME MEASURES: The results of pharmacological treatment. RESULTS: Many of the various treatments proved to be ineffective and only a few showed efficacy for a few weeks or months. The only effective drugs in the long term were baclofen, clonazepam, and clozapine. CONCLUSIONS: Until now, the phenomenon of SRPE is not well understood. The rarity of the published cases undoubtedly does not reflect the actual occurrence of SRPE. Controlled double-blind pharmacological trials are needed, and long-term follow-up including polysomnography coupled with nocturnal penile tumescence and rigidity monitoring may provide further information about SRPE.
INTRODUCTION: As specialists in male genital problems, urologists and sexologists will most likely to be involved in the treatment of males presenting with sleep-related painful erections (SRPEs). This means that this phenomenon needs to be recognized by urologists and sexologists, and that they should have knowledge of the current diagnostic and therapeutic approaches. Aim. To review the literature on SRPE and to find the best pharmacological treatment. Methods. Four personal clinical observations from two clinics and 29 other cases with SRPE found in PubMed were analyzed, especially regarding the results of pharmacological treatment. MAIN OUTCOME MEASURES: The results of pharmacological treatment. RESULTS: Many of the various treatments proved to be ineffective and only a few showed efficacy for a few weeks or months. The only effective drugs in the long term were baclofen, clonazepam, and clozapine. CONCLUSIONS: Until now, the phenomenon of SRPE is not well understood. The rarity of the published cases undoubtedly does not reflect the actual occurrence of SRPE. Controlled double-blind pharmacological trials are needed, and long-term follow-up including polysomnography coupled with nocturnal penile tumescence and rigidity monitoring may provide further information about SRPE.
Authors: Mark Johnson; Venkata McNeillis; Julia Gutbier; Andy Eaton; Robert Royston; Thomas Johnson; Giovanni Chiriaco; Miles Walkden; David Ralph Journal: Int J Impot Res Date: 2021-08-13 Impact factor: 2.408