Sleep‐Related Painful Erections in an Elderly Man Successfully Treated Using Clonazepam

Kuhadiya, Nitesh; Desai, Akshata; Reisner, Michelle

doi:10.1111/jgs.12667

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…Szücs AInformation already retrieved from an article written by Karsenty G et al in 20056. Neurological aspects of some sleep disorders [13]. Szúcs A.Irrelevant subject7.…”

Section: Methodsmentioning

confidence: 99%

Sleep related painful erection: an algorithm for evaluation and management

Abdessater

Kanbar

Zugail

et al. 2019

Basic Clin. Androl.

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BackgroundSleep related painful erection (SRPE) is a rare parasomnia consisting of nocturnal penile tumescence accompanied by pain that awakens the individual. Normal non-painful erections are experienced when awake. No penile anatomic abnormalities are present. No conclusive randomized clinical trial is present in the literature about the management of this rare condition. The aim of this article is to review the current knowledge about the management of SRPE and to suggest an algorithm to help physicians evaluate and manage SRPE.Material and methodsA literature review was conducted through PubMed database using the terms: sleep, pain, painful, penile, and erection. The reference lists of the articles were also reviewed. The search returned 23 references that were published between 1987 and 2019. Results were presented in a descriptive manner.ResultsTreatment decision for now is based on reports of the treatment success, the sustainability of remission, the tolerability by the patients and the potential side effects of each medication. From data available in literature, Baclofen is the mostly used medication with a tolerable profile of adverse effects. Phosphodiesterase type 5 inhibitors are considered potential treatments and are already widely used and tolerated for other indications, but so far only 2 successful trials have been reported for SRPE. Cinitapride is very promising, but only one case was studied and no side effects were reported. Clozapine can be very dangerous although highly effective.ConclusionBased on the limited number of treatment trials and reported cases, the low level of evidence and the lack of randomized clinical trials, no treatment consensus for SRPE can be reached. We suggested a useful tool for clinicians: an algorithm for the management of SRPE to facilitate their access to the literature without exhaustive return to case reports and series upon each case faced.

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“…Szücs AInformation already retrieved from an article written by Karsenty G et al in 20056. Neurological aspects of some sleep disorders [13]. Szúcs A.Irrelevant subject7.…”

Section: Methodsmentioning

confidence: 99%

Sleep related painful erection: an algorithm for evaluation and management

Abdessater

Kanbar

Zugail

et al. 2019

Basic Clin. Androl.

View full text Add to dashboard Cite

show abstract

“…Benzodiazepines such as diazepam as clonazepam have also been employed in the treatment of SPRE (38)(39)(40). Kuhadiya et al (41) describe a 77-year-old patient treated with 1 mg clonazepam once per night for 1 year who achieved good clinical results. Commonly used antidepressants including clomipramine, paroxetine, fluvoxamine, clozapine, amitriptyline, and sertraline are also used, having anticholinergic, antihistamine, and other antidepressant effects, as well as inhibiting REM sleep (38,40).…”

Section: Rem Inhibitorsmentioning

confidence: 99%

Narrative review: pathogenesis, diagnosis, and treatment of sleep-related painful erection

Wang¹,

Zhang²,

Liu³

2021

Transl Androl Urol

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Objective: Through critical analysis and comprehensive review of the limited literature, this paper can help clinicians better identify the pathophysiology of sleep-related painful erections (SRPE) and provide direction for future treatment research.Background: Patients with SRPE will be awakened by painful erections during sleep, which affects their sleep process and general health. At present, literatures of experimental and clinical research on SRPE disease are limited, as well as long-term reports on its pathogenesis and clinical management. Methods: We use the PubMed database to obtain sleep-related peer erection literature. The search terms used include sleep, painful, penis and erection. After rigorous screening, the search returned 21 references published between 1987 and 2021. Conclusions: The main cause of SRPE is obstructive sleep apnea (OSA) syndrome, psychological and spiritual factors, androgen elevation, neuroendocrine regulation and threshold of pain in the REM phase.The combination of multiple medications is the most effective approach to treat sleep-pain-related erections.The combination of CPAP, REM inhibitors and Baclofen has significant effect on SRPE caused by OSA syndrome. This article provides effective support and strategies for doctors to manage SRPE patients through a comprehensive analysis of the pathogenesis mechanism and clinical treatment strategies of SRPE.

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Sleep-Related Painful Erections in a Patient With Obstructive Sleep Apnea Syndrome

et al. 2015

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Sleep-related painful erection (SRPE) is a rare sleep disorder characterized by recurrent, painful penile erections occurring when awakening from rapid eye movement sleep, while erections are painless during wakefulness. Almost 35 cases have been reported worldwide, and only two of them had an associated obstructive sleep apnea syndrome (OSAS). We report a new case of a 61-year-old man suffering from SRPE associated with OSAS. The adequate treatment of respiratory events with continuous positive airway pressure did not alleviate the SRPE symptoms and excessive daytime sleepiness. The SRPE diagnosis was made by polysomnography coupled with video surveillance when the patient was referred to the sleep laboratory for residual excessive daytime sleepiness. The patient had 2-4 episodes of SRPE/night. Beta-blocker did not alleviate the SRPE, but a transient improvement was noted when the patient was treated with paroxetine. In contrast with the two previously published cases of SRPE plus OSAS, continuous positive airway treatment did not improve SRPE symptoms in our patient.

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Sleep‐Related Painful Erections in an Elderly Man Successfully Treated Using Clonazepam

Abstract: Nitesh D. Kuhadiya has received funding from the Endocrine Fellows Foundation to investigate the effects of liraglutide in type 1 diabetes mellitus.

Cited by 6 publications

References 4 publications

Sleep related painful erection: an algorithm for evaluation and management

Sleep related painful erection: an algorithm for evaluation and management

Narrative review: pathogenesis, diagnosis, and treatment of sleep-related painful erection

Sleep-Related Painful Erections in a Patient With Obstructive Sleep Apnea Syndrome

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