Abstract
Sleep-Related Painful Erection (SRPE) is a rare condition characterized by recurrent, painful penile erections occurring when awakening from the Rapid Eye Movement (REM) sleep stage. The cause of SRPE is still unknown, the therapeutic strategies still in an expert-based opinion phase and there is no consensus yet. We present a case of a 23-year-old patient suffering from SRPE for 1 year, the smart bracelet which has a sleep monitoring function showed his sleep was fragmented by awakenings at the end of all the REM period. Several treatments such as tamsulosin and highfrequency hyperthermia therapy and Chinese herbal medicine did not prompt any improvement of his condition, but after taking a single daily dose of paroxetine 20mg for twelves weeks, both the frequency and intensity of SRPE gradually decreased. Even though the antidepressants to which paroxetine belongs were included as one of the abandoned treatments in recent review, in our case, paroxetine showed a long-term and stable effect on patients with SRPE, it indicates that the therapeutic effect of paroxetine on SRPE deserves further study and observation.
Highlights
Sleep-related painful erection (SRPE) is a rare disorder defined as “penile pain that occurs during erections, typically during rapid eye movement episodes” [1], patients with SRPE often woke up several times a night with a deep painful erection, which results in serious sleep deprivation, leads to anxiety, depression, irritable and fatigue
We report a case of SRPE in a 23-year-old man successfully treated using paroxetine
Different from Nocturnal penile tumescence (NPT), SRPE is characterized by recurrent painful nocturnal penile tumescence that occurs during Rapid Eye Movement (REM) sleep in the absence of pain during intercourse and wakefulness
Summary
Sleep-related painful erection (SRPE) is a rare disorder defined as “penile pain that occurs during erections, typically during rapid eye movement episodes” [1], patients with SRPE often woke up several times a night with a deep painful erection, which results in serious sleep deprivation, leads to anxiety, depression, irritable and fatigue. A 23-year-old Chinese college student reported suffering from recurrent painful nocturnal erection during sleep for 1 year He woke up three to four times a night with a painful penile erection, the painful erection could be relieved by micturition. Blood and urine test, and brain MRI were performed, except the serum testosterone was 11.56ng/ml (normal range 1.42-9.23); other results did not showed any abnormal He denied taken any testosterone supplements or sexual stimulants. What’s more, his grandfather passed away two weeks later, he did not sleep for nearly 60 hours due to the customs and sadness mood, as a result, his condition became worse, the erection pain gradually increased to six to eight times a night, he felt extreme fatigue in the daytime. At-12-month follow-up, his only experienced noticeable nocturnal erections when he was very tired, but not accompanied by pain, he felt very satisfied
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