0971 Case Report: Sleep-Related Painful Erections Treated with Sodium Oxybate

Abstract Introduction Sleep-related painful erection (SRPE) is a rare parasomnia characterized by penile erections during rapid eye movement sleep. Normal, painless continue to occur while awake. Approximately thirty cases have been reported in the literature. Multiple theories about potential pathophysiology proposed including neurologic dysfunction of ischiocavernosus and bulbocavernosus, correlation with obstructive sleep apnea, and/or autonomic dysfunction. There no known single effective treatment date resulting durable response despite multiple attempts at therapy. Report case(s) A 39-year-old male presented SRPE. This started 2018 occurred second half night every twenty minutes, contributing discomfort poor quality. While awake, his were painless. He was prescribed baclofen doses up 30mg daily decreasing episode frequency 1-6 times per night, but disabling somnolence precluded continuation. Pelvic physiotherapy unhelpful imipramine clonazepam provided partial relief. Tadalafil ineffective cinitapride not available United States. Oxycodone used for pain after motor vehicle accident did effectively treat him five hours so morphine trialed. two weeks, symptoms returned. In April 2022, he begun on sodium oxybate. With an initial dose 2.25 g twice nightly, treated four night. After increasing 2.75 SRPE treated. As September taking oxybate 3 bedtime, 3.5 later final 7th hour, promoting 9.5 without Conclusion who trialed therapies success, ultimately successfully appropriate titrated may represent new option, which we hypothesize act modulating GABA result relaxation bulbospongiosus muscles. Further studies should include study both efficacy this drug as well mechanisms action. Support (if any)