For individuals suffering from a condition that affects sexual function, obtaining an accurate diagnosis is an important first step in the treatment process. It may seem simple, but unfortunately many sexual disorders have symptoms that overlap and present in similar ways, making it often difficult to determine the root cause of the problem. Stuttering priapism (SP) and sleep-related painful erections (SRPE) are two rare conditions that have similar symptoms and can cause painful erections at night, but are separate conditions that must be managed and treated in different ways. .
The researchers, including David Ralph, MS, FRCS, examined the similarities and differences between SP and SRPE to determine the most effective medical and surgical treatments for men with both conditions. Dr. Ralph, an accomplished urologist and microsurgeon who has conducted extensive research on several sexual medicine topics, including Peyronie's disease and erectile dysfunction (ED), said:[This study] This is important because it distinguishes between different types of painful nocturnal erections. mechanism [of these disorders] It may be different and the treatment may be different.”
Priapism is a prolonged, painful erection that is not associated with sexual stimulation and can last for several hours. This is an uncommon condition, but occurs more often in people with sickle cell disease (SCD), a genetic disorder that causes red blood cells to harden and become sticky, taking on a C-shaped “sickle” shape. SP is a type of ischemic “low-flow” priapism (IP), which occurs when blood does not flow properly back out of the penis. Men with SP experience recurrent, painful, and prolonged erections along with intermittent IP episodes (erections that last more than four hours). SP erections can occur at any time, but usually occur at night while the man is asleep. Like other forms of priapism, SP can cause fibrosis and lead to erectile dysfunction.
SRPE is a condition in which men experience painful erections during REM sleep but have normal, painless erections when awake. The cause of SRPE is unclear, but some early research suggests it may be related to stress and anxiety. Unlike patients with SP, men with SRPE do not have episodes of IP, and the disorder does not affect sexual function or lead to erectile dysfunction.
Given the similar symptoms of both conditions, it can be difficult to determine which condition a man is suffering from, which is problematic because different conditions require different treatment approaches. “SRPE is often treated as SP, but it can be a sleep disorder or a non-penile pathology,” says Dr. Ralph. The cause of both conditions is unknown, but in SRPE, penile structures may not be the cause of the symptoms.”
This study of 133 men with bothersome nocturnal erections (62 with sickle cell SP, 40 with non-sickle cell SP, and 31 with SRPE) found that the effects of red blood cells and hydroxyurea (a drug that helps maintain abnormal red blood cells) Autoexchange transfusion revealed. blood cell formation) was the most effective treatment option for men with sickle cell SP. Hormone manipulation and the drug ethylephrine were effective in both groups of SP patients. Baclofen, a drug used to treat muscle spasms, was the most effective treatment option for patients with SRPE. Finally, surgery in the form of penile prosthesis implantation was effective for men in the SP group but not for men in the SRPE group.
The findings highlight the importance of knowing the patient's medical history and making the correct diagnosis when treating sexual disorders. Further research into SP and SRPE will help determine the causes and unique characteristics of each condition.
David Ralph, MS, FRCS contributed to the article.
resource:
Centers for Disease Control and Prevention (CDC). (December 14, 2020). Sickle cell disease (SCD). https://www.cdc.gov/ncbddd/sicklecell/facts.html
Johnson, M. J., McNeillis, V., Chiriaco, G., & Ralph, D. J. (2021). Rare disorders of painful erections: A cohort study of the investigation and management of stuttering priapism and sleep-related painful erections. Journal of Sexual Medicine, 18(2), 376-384. https://www.jsm.jsexmed.org/article/S1743-6095(20)31056-0/fulltext
Mayo Clinic. (June 15, 2019). Priapism – Symptoms and Causes. https://www.mayoclinic.org/diseases-conditions/priapism/symptoms-causes/syc-20352005