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Spontaneous nocturnal erections—Physiology and clinical applications

Spontane nächtliche Erektionen—Physiologie und klinische Anwendungen

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Summary

Spontaneous nocturnal erections in men are a well-known phenomenon whose physiology however is not yet really understood. The measurement of nocturnal erections has gained clinical relevance for the diagnosis of erectile dysfunction because it allows an objective and quantitative assessment of the erectile capacity. A decisive advantage compared to other diagnostic tests carried out during wakefulness is the exclusion of psychological factors to a great extent. Thus, an evaluation of the organic component of an erectile dysfunction is possible. Regarding the interpretation of nocturnal erection records, various factors possibly influencing the results must be considered; this is particularly relevant if the method is applied in forensic evaluations. Registration of at least one normal nocturnal erection indicates that the penile structures are intact and that the organic requirements on the peripheral level for developing an erection are fulfilled. Abnormal nocturnal erection patterns can only be assessed correctly on the basis of a polysomnography carried out simultaneously. In case of an undisturbed sleep profile, missing or clearly diminished nocturnal erections point to organic causes of the erectile dysfunction. With the availability of very effective noninvasive treatment options for erectile dysfunction that are independent of aetiology, nocturnal erection measurement is not part of the routine diagnosis; rather, it is reserved for selected cases where the exact determination of the underlying causes is relevant.

Zusammenfassung

Spontane nächtliche Erektionen beim Mann stellen ein seit langem bekanntes Phänomen dar, dessen physiologische Grundlagen jedoch erst ansatzweise verstanden sind. Die Messung der nächtlichen Erektionen hat klinische Bedeutung bei der Diagnostik der erektilen Dysfunktion, da sie eine objektive und quantitative Beurteilung der erektilen Kapazität erlaubt. Entscheidender Vorteil gegenüber anderen im Wachzustand durchgeführten diagnostischen Methoden ist die weitgehende Ausschaltung psychischer Einflüsse. Somit kann eine Aussage zur organischen Komponente einer erektilen Dysfunktion gemacht werden. Bei der Interpretation ist eine Vielzahl von Einflussfaktoren zu berücksichtigen, die vor allem bei gutachterlichen Fragestellungen sorgfältig erfasst werden müssen. Der Nachweis mindestens einer normalen nächtlichen Erektion belegt, dass die penilen Strukturen intakt und damit die organischen Voraussetzungen zur Entwicklung einer Erektion auf der peripheren Ebene gegeben sind. Abnorme Muster nächtlicher Erektionen können nur im Zusammenhang mit einer gleichzeitig durchgeführten Polysomnographie korrekt beurteilt werden. Fehlende oder deutlich verminderte nächtliche Erektionen sprechen bei normalem Schlafprofil für eine organische Ursache der erektilen Dysfunktion. Nachdem heute sehr effektive nichtinvasive, dabei von der Ätiologie unabhängige Therapieoptionen zur Behandlung der erektilen Dysfunktion zur Verfügung stehen, stellt die Messung der nächtlichen Erektionen keine Routinemethode dar, sondern bleibt speziellen Indikationen vorbehalten, bei denen eine exakte ätiologische Klärung angestrebt wird.

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  1. Department of Psychiatry, University of Mainz, Mainz, Germany

    Klaus Mann

  2. Department of Urology, Markuskrankenhaus, Frankfurt, Germany

    Michael Sohn

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Mann, K., Sohn, M. Spontaneous nocturnal erections—Physiology and clinical applications. Somnologie 9, 119–126 (2005). https://doi.org/10.1111/j.1439-054X.2005.00057.x

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