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Erectile dysfunction in uremic patients and the effect of renal transplantation—our experience
Erectile Dysfunction in Uremic Patients and the Effect of Renal Transplantation—Our Experience B.S. Aulakh, S.K. Singh, S. Khanna, R. Kaura, and S. Goyal
T
HE AIM of the study was to evaluate the prevalence of erectile dysfunction in uremic patients and the impact of renal transplant on it. MATERIAL AND METHODS Twenty male uremic patients (age 18 –55 years) admitted for renal transplant from June 1998 to May 2002 were included in the study. They were evaluate for erectile function by using sexual function questionnaries,1 a nocturnal penile tumesence (NPT) test,2 and pharmacologically induced penile erection (PIPE) with papaverine3 on admission and 3 months after the transplantation. Patients having graft dysfunction were excluded from the study.
torial, namely depressed testosterone, vascular insufficiency, anemia, multiple medications, autonomic and somatic neuropathy, and psychological stress. According to Breza et al,4 41.5% of uremics had ED. Overall improvement in erectile function has been reported following transplantation.5 In our study, ED was present in 55% of uremic patients, improvement was observed in 63.63% after transplantation. The outlook for patients after successful renal transplantation has improved, including erectile function.
RESULTS
REFERENCES
Based on the questionnaries, 11 out of 20 (55%) patients had erectile dysfunction (ED) before transplantation. Seven of 11 patients experienced improved erectile function following transplantation. NPT was positive in 2 of these 11 patients with ED. There was a significant improvement in time of onset of erection (15.40 ⫾ 6.99 minutes vs 11.50 ⫾ 4.56 minutes, P ⬍ .05) and erectile angle (83.5 ⫾ 17.83 vs 95 ⫾ 13.60, P ⬍ .05) on the PIPE test. Four out of 9 patients who had no rigidity on PIPE test had improvement following transplantation. The difference in the duration of erection was, however, not significant.
1. Geisser ME, Murray FT, Cohen MS: J Androl 14:298, 1993 2. Barry JM, Blank B, Boilean M: Urology 15:171, 1980 3. Mouritsen L, Lyngdrof P, Frimodt-Moller C: Scan J Urol Nephrol 22:161, 1998 4. Breza J, Rezmeck J, Zvara P, et al; 94:489, 1993 5. Rodriguez R, Burgos RFJ, Gomez DV, et al: Actas Urol Espanolas 20:697, 1996
DISCUSSION
Chronic renal failure has been associated with impaired libido and erectile function. The mechanisms are multifac-
© 2003 by Elsevier Science Inc. 360 Park Avenue South, New York, NY 10010-1710 Transplantation Proceedings, 35, 315 (2003)
From the Departments of Urology and General Surgery, Dayanand Medical College and Hospital, Ludhiana, India (B.S.A., S.K., R.K., S.G.); and the Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India (S.K.S.). Address reprint requests to Dr B.S. Aulakh, 53-E, Rishi Nagar, Near Income Tax Colony, Ludhiana 141001, Punjab, India. E-mail: [email protected]
0041-1345/03/$–see front matter doi:10.1016/S0041-1345(02)03993-3 315
T
HE AIM of the study was to evaluate the prevalence of erectile dysfunction in uremic patients and the impact of renal transplant on it. MATERIAL AND METHODS Twenty male uremic patients (age 18 –55 years) admitted for renal transplant from June 1998 to May 2002 were included in the study. They were evaluate for erectile function by using sexual function questionnaries,1 a nocturnal penile tumesence (NPT) test,2 and pharmacologically induced penile erection (PIPE) with papaverine3 on admission and 3 months after the transplantation. Patients having graft dysfunction were excluded from the study.
torial, namely depressed testosterone, vascular insufficiency, anemia, multiple medications, autonomic and somatic neuropathy, and psychological stress. According to Breza et al,4 41.5% of uremics had ED. Overall improvement in erectile function has been reported following transplantation.5 In our study, ED was present in 55% of uremic patients, improvement was observed in 63.63% after transplantation. The outlook for patients after successful renal transplantation has improved, including erectile function.
RESULTS
REFERENCES
Based on the questionnaries, 11 out of 20 (55%) patients had erectile dysfunction (ED) before transplantation. Seven of 11 patients experienced improved erectile function following transplantation. NPT was positive in 2 of these 11 patients with ED. There was a significant improvement in time of onset of erection (15.40 ⫾ 6.99 minutes vs 11.50 ⫾ 4.56 minutes, P ⬍ .05) and erectile angle (83.5 ⫾ 17.83 vs 95 ⫾ 13.60, P ⬍ .05) on the PIPE test. Four out of 9 patients who had no rigidity on PIPE test had improvement following transplantation. The difference in the duration of erection was, however, not significant.
1. Geisser ME, Murray FT, Cohen MS: J Androl 14:298, 1993 2. Barry JM, Blank B, Boilean M: Urology 15:171, 1980 3. Mouritsen L, Lyngdrof P, Frimodt-Moller C: Scan J Urol Nephrol 22:161, 1998 4. Breza J, Rezmeck J, Zvara P, et al; 94:489, 1993 5. Rodriguez R, Burgos RFJ, Gomez DV, et al: Actas Urol Espanolas 20:697, 1996
DISCUSSION
Chronic renal failure has been associated with impaired libido and erectile function. The mechanisms are multifac-
© 2003 by Elsevier Science Inc. 360 Park Avenue South, New York, NY 10010-1710 Transplantation Proceedings, 35, 315 (2003)
From the Departments of Urology and General Surgery, Dayanand Medical College and Hospital, Ludhiana, India (B.S.A., S.K., R.K., S.G.); and the Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India (S.K.S.). Address reprint requests to Dr B.S. Aulakh, 53-E, Rishi Nagar, Near Income Tax Colony, Ludhiana 141001, Punjab, India. E-mail: [email protected]
0041-1345/03/$–see front matter doi:10.1016/S0041-1345(02)03993-3 315