title: Effects of hypoxia on nocturnal erection quality: a case report from the Manaslu expedition.
abstract: BACKGROUND
  High altitude environment represents a fine model to study physiological and pathophysiological effects of oxygen availability on sleep-related erections (SREs).
  
  
  OBJECTIVE
  To describe altitude-dependent effects on quality of SREs in order to estimate the role of hypoxia in erection physiology.
  
  
  METHODS
  A healthy 37-year-old male mountain climber underwent a chronic high altitude-related hypoxia experience during the 43 days of the Manaslu expedition (Nepal). SREs were recorded by RigiScan (Timm Medical Technologies, Inc., Eden Prairie, MN, USA) at altitudes ranging from 0 to 5,800 m above sea level. The erection-related parameters assessed were: number, duration, event duration (% of session), event rigidity %, time rigidity %, tumescence and rigidity activated unit, and event tum % > bline (%).
  
  
  METHODS
  SREs were recorded by RigiScan at altitudes ranging from 0 to 5,800 m above sea level.
  
  
  RESULTS
  Erectile parameters showed an altitude-related reduction during the hypoxic exposure, although all functional alterations were reverted by the return to sea level.
  
  
  CONCLUSIONS
  Our case report supports the hypothesis that oxygen availability and delivery could play an important role in the regulation of local penile erection-related mechanisms and that low oxygen levels might be considered an etiological cofactor in erectile dysfunction.
authors: Department of Neurosciences and Imaging, University of Chieti, Chieti, Italy. vittorelibero@hotmail.it
authors: Vittore
authors: V
authors: Verratti
authors: Stefano
authors: S
authors: Falone
authors: Giorgio
authors: G
authors: Fanò
authors: Antonio
authors: A
authors: Paoli
authors: Carlo
authors: C
authors: Reggiani
authors: Raffaele
authors: R
authors: Tenaglia
authors: Camillo
authors: C
authors: Di Giulio