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Sleep related painful erection: an algorithm for evaluation and management.

Maher Abdessater1, Anthony Kanbar1, Ahmed S Zugail1

  • 1Groupe hospitalier Diaconesses - Croix Saint Simon, Paris- France, 5 quai bucherelle, 95300 Pontoise, France.

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Sleep related painful erection (SRPE) is a rare condition causing painful nocturnal erections. Current treatments lack consensus, but an algorithm can guide physician evaluation and management.

Keywords:
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Area of Science:

  • Neurology
  • Sleep Medicine
  • Urology

Background:

  • Sleep related painful erection (SRPE) is a rare parasomnia characterized by nocturnal penile tumescence with pain.
  • It is distinct from normal erections and occurs without penile anatomical abnormalities.
  • There is a lack of conclusive randomized clinical trials for SRPE management.

Purpose of the Study:

  • To review current knowledge on the management of SRPE.
  • To propose an algorithm to aid physicians in evaluating and managing SRPE.

Main Methods:

  • A literature review was performed using the PubMed database.
  • Search terms included: sleep, pain, painful, penile, and erection.
  • Twenty-three relevant references published between 1987 and 2019 were analyzed.

Main Results:

  • Treatment decisions are based on efficacy, remission sustainability, tolerability, and side effects.
  • Baclofen is frequently used with a tolerable side effect profile.
  • Other potential treatments include PDE5 inhibitors and Cinitapride, with limited reported cases for SRPE.

Conclusions:

  • No definitive treatment consensus exists for SRPE due to limited evidence and lack of randomized trials.
  • An algorithm is proposed to assist clinicians in managing SRPE cases efficiently.
  • The algorithm aims to simplify literature access for physicians encountering SRPE.