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2017 ; 5
(4
): e237-e243
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Sleep-Related Painful Erections-A Case Series of 24 Patients Regarding
Diagnostics and Treatment Options
#MMPMID29066083
Vreugdenhil S
; Weidenaar AC
; de Jong IJ
; van Driel MF
Sex Med
2017[Dec]; 5
(4
): e237-e243
PMID29066083
show ga
BACKGROUND: Patients with sleep-related painful erections (SRPEs) have deep
penile pain during nocturnal erection that wakes them up and disturbs their
nights of sleep. This rare parasomnia is poorly recognized by general
practitioners and by urologists and sexologists. AIM: To gain more insight into
diagnostics and therapeutic options. METHODS: Data from a series of 24
consecutive patients who presented with SRPEs at the outpatient clinic from 1996
to 2015 were retrospectively analyzed. Additional questionnaires were completed
to complement data and to obtain information about follow-up. Long-term treatment
efficacy of baclofen was assessed using the Wilcoxon signed rank test. OUTCOMES:
SRPEs were not associated with urologic, surgical, or psychiatric history or with
serum testosterone levels. The mean doctors' delay was 3.5 years. 14 of the 24
patients were treated with baclofen (10-75 mg). In 11 of them, complete remission
was observed within a few weeks. 2 of the 3 remaining patients noticed a slight
improvement of SPRE symptoms and only 1 patient experienced no effect at all.
After an average follow-up of 4.5 years, only 41.6% of patients who had used
baclofen were satisfied with their SRPEs. The others (58.4%) were dissatisfied,
mostly owing to relapse of symptoms after the discontinuation of baclofen. Other
treatment forms were applied sporadically, with strongly varying results.
CLINICAL IMPLICATIONS: This overview of SRPE contributes to a better clinical
understanding and recognition of the phenomenon and provides new, more
constructed advice about therapeutic implications, especially concerning the use
of baclofen. STRENGTHS AND LIMITATIONS: This study provides a systematic overview
of a relatively large series of patients with SRPE, which provides substantiated
treatment advice. However, treatment efficacy was based mainly on the patients'
subjective perception and it was not possible to compare the results of baclofen
with other forms of pharmacologic treatment, because these alternative drugs were
applied only sporadically. Nevertheless, this study is directional for future
research. CONCLUSIONS: This study confirmed a long doctors' delay in patients
with SRPE. There was no association between SRPEs and comorbidity and total serum
testosterone levels. Treatment with baclofen proved successful and safe in the
short term. Long-term feasibility needs further investigation. Vreugdenhil S,
Weidenaar AC, de Jong IJ, van Driel MF. Sleep-Related Painful Erections-A Case
Series of 24 Patients Regarding Diagnostics and Treatment Options. Sex Med
2017;5:e237-e243.