title: The treatment of sleep-related painful erections.
abstract: BACKGROUND
  As specialists in male genital problems, urologists and sexologists will most likely to be involved in the treatment of males presenting with sleep-related painful erections (SRPEs). This means that this phenomenon needs to be recognized by urologists and sexologists, and that they should have knowledge of the current diagnostic and therapeutic approaches. Aim. To review the literature on SRPE and to find the best pharmacological treatment. Methods. Four personal clinical observations from two clinics and 29 other cases with SRPE found in PubMed were analyzed, especially regarding the results of pharmacological treatment.
  
  
  METHODS
  The results of pharmacological treatment.
  
  
  RESULTS
  Many of the various treatments proved to be ineffective and only a few showed efficacy for a few weeks or months. The only effective drugs in the long term were baclofen, clonazepam, and clozapine.
  
  
  CONCLUSIONS
  Until now, the phenomenon of SRPE is not well understood. The rarity of the published cases undoubtedly does not reflect the actual occurrence of SRPE. Controlled double-blind pharmacological trials are needed, and long-term follow-up including polysomnography coupled with nocturnal penile tumescence and rigidity monitoring may provide further information about SRPE.
authors.affiliation: Department of Urology, University of Groningen, Groningen, the Netherlands;. Electronic address: m.f.van.driel@uro.umcg.nl.
authors.forename: Mels F
authors.initials: MF
authors.lastname: van Driel
authors.affiliation: Department of Urology, University of Leiden, Leiden, the Netherlands.
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Beck
authors.affiliation: Department of Urology, University of Leiden, Leiden, the Netherlands.
authors.forename: Henk W
authors.initials: HW
authors.lastname: Elzevier
authors.affiliation: Department of Neurophysiology, University of Groningen, Groningen, the Netherlands.
authors.forename: Johannes H
authors.initials: JH
authors.lastname: van der Hoeven
authors.affiliation: Department of Urology, University of Groningen, Groningen, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Nijman
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D018755:GABA Agonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011317:Priapism / Q000175:diagnosis / Q000188:drug therapy*; D012890:Sleep / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D018755:GABA Agonists