Johnson, Mark James;
(2025)
Sleep-Related Painful Erections and Stuttering Priapism.
Doctoral thesis (M.D(Res)), UCL (University College London).
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Abstract
Stuttering Priapism (SP) and Sleep-related Painful Erection (SRPE) are rare disorders of penile erection. They share similar clinical features and due to this, can incorrectly be treated as the same condition. In both groups, affected men experience painful, bothersome nocturnal erections. Often, their primary complaint is related to poor sleep and daytime fatigue. This thesis has found multiple key differences using polysomnography, nocturnal penile tumescence and ultrasound Doppler that suggest a difference in pathophysiology between these conditions and, as such, suggests that they should be described and treated as two separate entities. The prognosis of these two conditions has also been found to be different. Men with poorly controlled SP (often young men with sickle cell disease) are at significant risk of permanent erectile dysfunction and fibrosis of the corporal bodies. In contrast, men with SRPE experience shorter, more frequent episodes with significantly disrupted sleep. Affected men are significantly bothered by their symptoms; however, there is no association with erectile dysfunction and the condition does not appear to progress. Due to the rarity of these diagnoses, similarities of their presentation and the potential devastating consequences of SP; men in both groups have often been treated with anti-androgen medications that have significant side effects, including sexual dysfunction, cardiovascular disease and reduced bone mineral density. In the case of an escalating SP, this may be appropriate based on risk/benefit. In contrast, men with SRPE have very bothersome symptoms; however, due to the difference in pathophysiology and prognosis, anti-androgen therapy could be considered significant overtreatment. This thesis and associated scientific papers are the first evidence in the literature to look at the key differences between these two conditions with the aim of achieving appropriate diagnosis and management in both groups of men.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D(Res) |
| Title: | Sleep-Related Painful Erections and Stuttering Priapism |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10208646 |
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