Erectile function in end-stage renal disease before and after renal transplantation

Abstract

Introduction. Erectile function in end-stage renal disease (ESRD) and renal transplant patients is a challenging issue. In this study we evaluated the prevalence of erectile dysfunction (ED) according to standard questionnaires and paraclinical tests including Rigiscan. Materials and methods. We conducted a prospective, interventional, nonrandomized study of 15 consecutive male patients who underwent living donor renal transplants from March 2003 to June 2004. Before and after living donor transplantation we did hormone assays, blood ionogram and biochemistry, complete blood counts, u/a, international index of erection function 5 (IIEF-5), erection dysfunction intensive score (EDIS) tests as well as Rigiscan. Results. The patient ages were between 21 and 50 (average 35.26) years, with an average length of ESRD of 4.31 years. Of the patients, 73.33% were smokers; 46.66% had ED; and 40%, hypertension. The most common blood groups were B-positive and O-positive (33.3% each). Mean testosterone and prolactin levels showed significant decreases after renal transplantation (P = .001 and P = .005, respectively). Mean blood glucose also decreased significantly (P = .035), despite previous reports that immunosuppressive drugs cause pseudodiabetes mellitus, mean cholesterol and triglyceride levels decreased after renal transplantation (P = .013, P = .0668, respectively). Urinalysis did not differ significantly after renal transplantation. Mean urea and creatinine levels were decreased significantly by renal transplantation (P = .000 and P = .003, respectively), but neither the mean values of uric acid nor the blood cell count were significantly different (P = .374). Mean hemoglobin and hematocrit levels were increased by renal transplantation, but it was not significant (P = .297 and P = .187, respectively). Mean potassium and phosphorus level were significantly decreased (P = .049 and P = .047, respectively), but mean sodium and calcium levels were not significantly altered (P = .773 and P = .536, respectively). Mean total and direct bilirubin and liver enzymes and alkaline phosphatase and LDH also did not change significantly. IIEF-5 was improved in 11 cases, unchanged in two cases, and worsened in another two cases. Nocturnal penile tumescence (Rigiscan test) was also improved in 11 cases, unchanged in three cases, and worsened in one case. The prevalence of erectile function was increased according to the EDIS question. Conclusion. Erectile function was improved after successful live donor renal transplant. © 2005 Elsevier Inc. All rights reserved.