INTRODUCTION: High altitude environment represents a fine model to study physiological and pathophysiological effects of oxygen availability on sleep-related erections (SREs). AIM: To describe altitude-dependent effects on quality of SREs in order to estimate the role of hypoxia in erection physiology. METHODS: A healthy 37-year-old male mountain climber underwent a chronic high altitude-related hypoxia experience during the 43 days of the Manaslu expedition (Nepal). SREs were recorded by RigiScan (Timm Medical Technologies, Inc., Eden Prairie, MN, USA) at altitudes ranging from 0 to 5,800 m above sea level. The erection-related parameters assessed were: number, duration, event duration (% of session), event rigidity %, time rigidity %, tumescence and rigidity activated unit, and event tum % > bline (%). MAIN OUTCOMES MEASURES: SREs were recorded by RigiScan at altitudes ranging from 0 to 5,800 m above sea level. RESULTS: Erectile parameters showed an altitude-related reduction during the hypoxic exposure, although all functional alterations were reverted by the return to sea level. CONCLUSIONS: Our case report supports the hypothesis that oxygen availability and delivery could play an important role in the regulation of local penile erection-related mechanisms and that low oxygen levels might be considered an etiological cofactor in erectile dysfunction.
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