Sleep-related erections: Neural mechanisms and clinical significance

Schmidt, Markus H.; Schmidt, Helmut S.

doi:10.1007/s11910-004-0033-5

Cited by 50 publications

(40 citation statements)

References 46 publications

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“…Recent data suggest that erections may also be related to other nerve centers, such as the olfactory nucleus, the amygdala, and the bed nucleus of the stria terminalis, which favor erection through olfactory stimuli, and the medial preoptic area, which plays an important role in copulatory behavior. However, these structures do not act directly on the spinal cord, but, instead, act through the nPGi and PVN (Hirshkowitz & Schmidt, 2005;Schmidt & Schmidt, 2004).…”

Section: Physiology Of Penile Tumescencementioning

confidence: 99%

“…The lateral preoptic area has been described as a center of slow-wave sleep generation; moreover, it contains a group of neurons that only act during REM sleep and are inactive during slow-wave sleep and wakefulness. This group of cells has been associated with generation of REM sleep erections, although indirectly, through the PVN and nPGi (Hirshkowitz & Schmidt, 2005;Schmidt, Sakai, Valatx, & Jouvet, 1999;Schmidt & Schmidt, 2004;Schmidt, Valatx, Sakai, Fort, & Jouvet, 2000). dition with a prevalence of around 1% of patients who present erectile or sexual problems (Calvet, 1999;Ferini-Strambi et al, 1996b;Matthews & Crutchfield, 1987;Steiger & Benkert, 1989).…”

Section: Physiology Of Penile Tumescencementioning

confidence: 99%

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Sleep-Related Painful Erections Associated with Obstructive Sleep Apnea Syndrome

et al. 2012

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Sleep-related painful erection is a rare syndrome recognized by reports of painful nocturnal erection, an association between REM sleep and pain, and the absence of pain during wakeful sexual activity. Approximately 30 cases have been reported in the literature. We add two more cases, each of which seemed to be associated with severe sleep apnea. Treatment of the apnea with Continuous Positive Airway Pressure device lessened the symptom in both men. Implications of this association are discussed.

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Section: Physiology Of Penile Tumescencementioning

confidence: 99%

Section: Physiology Of Penile Tumescencementioning

confidence: 99%

Sleep-Related Painful Erections Associated with Obstructive Sleep Apnea Syndrome

et al. 2012

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“…However, its role has been challenged. A normal NPT entails four to six episodes of nocturnal erections lasting 15–50 minutes—measuring 70%—if RigiScan (Dacomed Corporation, Minneapolis, MN, USA) device is used during a 6‐ to 8‐hour sleep cycle [34,35].…”

Section: Nocturnal Penile Tumescence (Npt) Testingmentioning

confidence: 99%

An Evidence-Based Perspective to Commonly Performed Erectile Dysfunction Investigations

Ghanem

Shamloul

2008

The Journal of Sexual Medicine

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Introduction Currently there is no universally accepted gold standard diagnostic test to differentiate psychogenic from physical erectile dysfunction (ED). Instead, sexual health specialists rely on a detailed history, a focused physical examination, and specialized diagnostic tests, to decide if the etiology of the ED is mainly psychogenic or organically caused. Aim In this review we point out the status of evidence-based principles in the area of diagnosis in Sexual Medicine. Methods We review the concepts of evidence-based medicine (EBM) in the area of medical diagnostic tests. We highlight four of the well-known diagnostic tests (penile duplex, pharmacoarteriography, pharmacocavernosometry/cavernosography [PHCAS/PHCAG], and nocturnal penile tumescence [NPT monitoring]) for ED evaluation within an evidence-based perspective. Main Outcome Measures Assessment of diagnostic tests for ED using principles of EBM. Results Several good diagnostic tests are useful in the evaluation of men with ED. However, modern evidence-based concepts—mainly the likelihood ratio—have not yet been applied to these tests to obtain their maximum clinical benefits. Conclusions While penile duplex/color Doppler has good evidence of supporting its use in the diagnosis of arteriogenic ED, data supporting its diagnosis of a physical disorder associated with cavernous venous occlusion dysfunction are lacking. PHCAS/PHCAG's main drawback is an unknown positive predictive value and a possibility of frequent false-positive results. NPT has many advantages when differentiating psychogenic from organic ED, however, several questions related to its physiological mechanisms do exist. [Correction added after online publication 14-Dec-2007: In the above reference for this article, the order of the author names has been updated.]

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“…Impairment of lower urinary tract and erectile function following SCI in humans and the subsequent complications are highly prevalent and clinically very important (1,16), necessitating continued research with respect to the pathophysiology and treatments to improve recovery. Telemetric monitoring of CSP pressure has previously been applied in studies of sleeprelated erections (30,32), ex copula penile erections (31), and SCI (18), but its validation with respect to micturition has been lacking. A recent comprehensive review of urologic and sexual dysfunction (15) makes no mention of this technique, highlighting the importance of validation of the technique as performed in this study.…”

mentioning

confidence: 99%

Novel technique for monitoring micturition and sexual function in male rats using telemetry

Nout¹,

Bresnahan²,

Culp³

et al. 2007

American Journal of Physiology-Regulatory, Integrative and Comp

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We developed a novel technique to simultaneously monitor micturitions and erections in rats by using pressure monitoring within the corpus spongiosum of the penis (CSP). We present data validating this technique and report pressure waveform characteristics of micturition and erectile events during four different behavioral contexts in 10 awake, freely-moving male rats. Telemetric pressure transducers were implanted in the bulb of the CSP. CSP pressure was monitored while the animals were simultaneously recorded on video for determination of presence and volume (n = 7) of micturitions and while the animals underwent behavioral tests for determination of erections. Observed micturitions and CSP pressure waveforms characteristic of micturitions occurred simultaneously (r = 0.98) at a frequency of 32 +/- 4 micturitions per 24 h and with a volume of 0.95 +/- 0.12 ml/urination. Micturition duration recorded by CSP pressure and volume determined by urine weight were highly correlated (r = 0.82). We found that 100% of visually confirmed erectile events occurred simultaneously with CSP pressure waveforms characteristic of erections during ex copula reflex erection tests. During noncontact erection and mating tests more erections were identified by telemetry than by observation alone. Erections during mating tests had a different appearance than those seen in other contexts; they were shorter in duration (P < 0.05) and typically were characterized by a single suprasystolic CSP pressure peak, highlighting the context-specificity of erections. Quality of recordings remained stable in three of four rats we followed for 8 wk. We demonstrate that telemetric recording of CSP pressure provides a quantitative and qualitative assessment of penile erections and micturition in freely behaving rats.

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Sleep-related erections: Neural mechanisms and clinical significance

Cited by 50 publications

References 46 publications

Sleep-Related Painful Erections Associated with Obstructive Sleep Apnea Syndrome

Sleep-Related Painful Erections Associated with Obstructive Sleep Apnea Syndrome

An Evidence-Based Perspective to Commonly Performed Erectile Dysfunction Investigations

Novel technique for monitoring micturition and sexual function in male rats using telemetry

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