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Penile erections and hypersexuality induced by pergolide treatment in advanced, fluctuating Parkinson's disease
      
Spontaneous nocturnal erections-Physiology and clinical applications
      
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.
      
In case of an undisturbed sleep profile, missing or clearly diminished nocturnal erections point to organic causes of the erectile dysfunction.
      
There have been several advances in the understanding of the physiologic and biochemical mechanisms controlling penile erections.
      
Sleep-related erections: Neural mechanisms and clinical significance
      
Penile erections during rapid eye movement (REM) sleep are a robust physiologic phenomenon in all normal healthy males, irrespective of age.
      
Given the involuntary nature of erections in sleep, sleep-related erection (SRE) testing has been used to differentiate psychogenic from organic impotence.
      
Effects of bupropion sustained-release on sexual functioning and nocturnal erections
      
Due to the loss of protective erections during REM sleep, some researchers have suggested that SAS may be a risk factor for ED.
      
The literature evidence suggests that lack of natural erections during this period of time produces cavernosal hypoxia.
      
The introduction of the oral agent sildenafil 2 years ago has revolutionized the treatment of men with compromised erections and has met with expected success and low morbidity.
      
Clinicians now benefit from advances in the understanding of the physiologic pathways involved in the function of erections and from the availability of innovative and effective therapies.
      
In a randomized, controlled study, the use of the CaverMap during radical prostatectomy resulted in improved nocturnal erections, but did not lead to improved overall sexual function.
      
Early penile rehabilitation with intracavernosal injections or vacuum constriction devices should be encouraged to increase chances for recovery of rigid erections.
      
Twenty milligrams of vardenafil has sustained long-term efficacy by providing up to 92% of patients with improved erections during more than 2 years of treatment.
      
Time following radical prostatectomy has been shown to increase erectile function such that more patients have functional erections at 3 years than 1 year after surgery.
      
With the advent of phosphodiesterase-5 (PDE-5) inhibitors, many men can have improved functional erections and return to active coitus.
      
In doses of 10-20 μg, PGE1 produces full erections in 70-80% of patients with erectile dysfunction.
      
 

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