A 35-Year-Old Man Presenting Sleep-Related Painful Erections (Erpes): A Case Report and Review of Literature

Daniel de Freitas G. Soares, Ernani Luis Rhoden

Federal University of Health Sciences (UFCSPA), Porto Alegre, Brazil.

DOI: 10.4236/asm.2014.41002                

Abstract

Introduction: Erectile episodes occurring in the night time are considered normal and are usually related to the REM sleep. Spontaneous painful erections are unusual but they can have a great impact in the patient’s quality of sleep and, for consequence, quality of life. Report: We present a patient who has been presenting painful erections which wake him up almost every night. We discuss the workup and treatment offered to the patient, as well as the short-time response and two months follow-up. Discussion: Although studies still do not explain this relationship, nocturnal erections occur only during rapid eye movement (REM) sleep, which can be confirmed by polysomnography accompanied by Nocturnal Penile Tumescence testing or RigiScan test. However, diagnosis can be established based exclusively on clinical aspects. Based on all literature reviewed, the initial treatment should safely consist in improvement in sleep architecture and pelvis muscles relaxation. Conclusion: After the first suspicion, polysomnography with rigidity measurements of nocturnal erections should be considered although clinical diagnosis and therapeutic test may be acceptable. The management we suggest is usually effective, well tolerated and sustained.

Keywords

Painful Erection; Priapism; Nocturnal Erections; REM-Sleep

Conflicts of Interest

The authors declare no conflicts of interest.

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