Efficacy of testosterone gel in the treatment of erectile dysfunction in hypogonadal hemodialysis patients: a pilot study

Abstract

End-stage renal disease (ESRD) affects sexual function. The etiology of sexual dysfunction in ESRD is multifactorial and hypogonadism is not uncommon. In a cohort of 96 men with ESRD, scores on International Index of Erectile Function (IIEF) correlated with bioavailable testosterone (T; Po0.01). We further evaluated the effects of administration of T on ED in hypogonadal men on hemodialysis. Nine men with ED and hypogonadism (baseline bioavailable T o3.82 nmol l À1 ), received 5 g T-gel (1% (10 mg g À1 ) per day treatment for 6 months. The IIEF and frequency of sexual intercourse per week were used to assess treatment efficacy. T administration significantly increased serum T levels to the normal range, and was associated with statistically significant improvements of the scores of the IIEF domains (erectile function from 7.6 ± 8.0 to 12.8 ± 7.8; intercourse satisfaction from 3.4 ± 4.5 to 4.8 ± 3.1; orgasmic function from 4.8 ± 3.1 to 3.4±2.9; sexual desire from 3.4±2.9 to 4.4±0.6; overall sexual satisfaction from 2.6±1.3 to 3.8±1.0). But scores of the IIEF did not normalize. Frequency of weekly sexual intercourse increased from 0.4 ± 0.4 to 1.1 ± 0.8 (Po0.05) after 6 months. There were no adverse effects. We conclude that restoring T levels to normal in men with ESRD improved scores on the IIEF and frequency of weekly sexual intercourse.

Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options

“…However, in these studies, many of the patients who received testosterone were not frankly hypogonadal. In agreement with this, a recent noncontrolled study in 9 HD male patients with hypogonadism showed that therapy with transdermal testosterone gel effectively restored testosterone levels to the normal range, and significantly improved erectile function, sexual desire, orgasmic function and overall sexual satisfaction (134). Although nowadays androgen supplementation is seldom used for the treatment of anemia in ESRD, some studies have shown that the combination of intramuscular androgens and rhEPO increased hemoglobin levels beyond the effect of either alone (77,(135)(136)(137).…”

Quality of Life of Greek Patients With End Stage Renal Disease Undergoing Haemodialysis

“…Cabergoline and bromocryptine reduce serum prolactin levels and either can be used in selected patients (Biller et al 1996). Testosterone gel has been successfully used in the treatment of erectile dysfunction in hypogo‐nadal haemodialysis patients (Cangüven et al 2010). Alternative options in the management of the erectile dysfunction are vacuum tumescence device and administration of zinc (Lessan‐Pezeshki & Ghazizadeh 2008).…”

Male Sexual Dysfunction and Chronic Kidney Disease

“…Contra-indications include the presence of prostate cancer or palpable prostatic nodules, PSA above 4 ng/ml, untreated severe obstructive sleep apnea, and prostatic hypertrophy causing severe lower urinary tract symptoms. Benefits of correcting hypogonadism might include improvements in ED, as evidenced by two small uncontrolled case series (105, 106), although a third study found little gain from treatment (107). …”