Erectile function in men with end-stage liver disease improves after living donor liver transplantation

Abstract

BackgroundImpaired liver function in men can result in erectile dysfunction or hypogonadism or both. We investigated whether living donor liver transplantation (LDLT) results in improvement in male sexual function.MethodsA total of 58 patients with end-stage liver disease (ESLD) were included in this prospective, cross-sectional study. Erectile function was measured before and after LDLT using a five-item modified version of the International Index of Erectile Function scale (IIEF-5) and hypogonadism was evaluated before and after LDLT using the Androgen Deficiency in the Aging Male (ADAM) questionnaire. Differences in mean values from the questionnaires before and after the operation were than evaluated to determine whether there is an association between LDLT and improvement in sexual function.ResultsWe found that mean IIEF-5 scores significantly increased after LDLT (from 11.7 ± 7.7 before LDLT to 14.7 ± 7.5 after LDLT, p <0.01), indicating that the operation played a role in improving erectile function. In addition, the prevalence of hypogonadism among the patients with ESLD decreased markedly after liver transplantation (hypogonadism before LDLT, n = 41 versus hypogonadism after LDLT, n = 31, p = 0.03). Patients with hypogonadism reported a higher prevalence of erectile dysfunction after LDLT than patients without hypogonadism (p <0.01).ConclusionsLDLT results in improvement in erectile function. In addition, improvement in erectile function is associated with self-reported absence of hypogonadism.

Effects of liver transplantation on endocrine function: a systematic review

“…. The analysis included ten prospective studies , five retrospective studies and six cross‐sectional studies . Healthy controls were used for comparison in five studies .…”

“…A total of 11 studies in which the effect of LT on sexual function was assessed were included in the analysis .…”

“…Surrogate measures used to evaluate sexual function varied among the included studies. Three studies used the International Index of Erectile Function (IIEF) and/or the Female Sexual Function Index (FSFI) , whereas the remaining studies used various questionnaires to assess sexual function and satisfaction . All but one study reported that sexual function improved after LT (Table ).…”

“…Database searches identified 5028 articles, of which 668 were duplicates. After screening the titles and abstracts and completing a detailed evaluation of full-text articles, we identified 20 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) studies that met our inclusion criteria. At this stage, one study was excluded because of the short follow-up duration of the hormone levels (7 days), as surgical stress, body fluid shifts and postoperative graft dysfunction might have impacted endocrine function and represented a source of bias in our analysis (30).…”

“…A total of 11 studies in which the effect of LT on sexual function was assessed were included in the analysis (15,16,19,(22)(23)(24)(25)(26)(27)(28)(29). Table 2 shows the endpoints used and main results regarding sexual function as assessed before and after LT.…”