Sleep-related painful erections.
BACKGROUND
A 45-year-old man presented with repeated awakenings at night caused by nocturnal painful erections, in sharp contrast with normal erections at other times, 2 years after surgical removal of a thoracic (Th6-7) ependymoma.


METHODS
Physical examination, pharmaco-sensitized penile Doppler ultrasound, spinal and brain MRI, neurophysiological work-up (tibial and perineal somatosensory-evoked potential; hand, foot and perineal sympathetic skin response assessment), polysomnography with recording of nocturnal penile tumescence.


METHODS
Sleep-related painful erections, characterized by penile pain during nocturnal erection, typically during rapid eye movement sleep, in the presence of a residual thoracic spinal cord syndrome.


RESULTS
Amitriptyline, an antidepressant that suppresses rapid eye movement sleep, was ineffective. Treatments with other antidepressants, clozapine and beta-blockers were suggested, but the patient declined because of potential severe side effects.
Salvator University Hospital, Marseille, France. gilles.karsenty@ap-hm.fr
Gilles
G
Karsenty
Esther
E
Werth
Peter A
PA
Knapp
Armin
A
Curt
Brigitte
B
Schurch
Claudio L
CL
Bassetti
D020210:Central Cord Syndrome / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011317:Priapism / Q000209:etiology*; D012890:Sleep