High Prevalence of Erectile Dysfunction After Renal Transplantation

Malavaud, Bernard; Rostaing, Lionel; Rischmann, P.; Sarramon, Jean‐Pierre; Durand, Dominique

doi:10.1097/00007890-200005270-00027

Cited by 91 publications

(70 citation statements)

References 13 publications

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“…These findings are in line with those reported by others. 2 In this study, no statistically significant relationship between the haemodynamic parameters and cyclosporin A blood level could be demonstrated. These findings are supported by Ragazzi et al 17 who 18 Also cyclosporin A induces hypertension.…”

Section: Discussioncontrasting

confidence: 58%

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Role of penile vascular insufficiency in erectile dysfunction in renal transplant recipients

et al. 2002

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The objectives of this study were to define the role and haemodynamic features of penile vascular insufficiency in impotent renal transplant recipients (RTR) as well as to establish the possible vascular risk factors for impotence in these patients. A total of 54 RTR (35 impotent and 19 potent) and 21 potent healthy subjects were included in this study. All patients were assessed clinically and by measurement of serum creatinine, serum bilirubin, cyclosporine blood levels, haemoglobin and total serum cholesterol. All subjects were subjected to intracavernous injection of 20 mg prostaglandin E 1 followed by colour Duplex sonographic examination. Our results showed that impotent RTR were significantly more likely than potent RTR to have hypertension, diabetes and hypercholesterolaemia (P < 0.05). Arterial occlusive disease was identified in 42.9% of impotent RTR. Findings suggestive of veno-occlusive dysfuntion were found in 68.6% and 26.3% of impotent and potent RTR, respectively (P ¼ 0.003). Unilateral ligation of the internal iliac artery has a negative role on haemodynamic parameters compared to unilateral end-to-side anastomosis to external iliac artery in impotent RTR (P < 0.05). Impotent RTR receiving more than one antihypertensive drug showed significant decrease in basal peak systolic velocity (PSV), dynamic PSV, erectile angle and cavernosal artery diameter compared to those receiving one drug (P < 0.05). In conclusion, penile vascular insufficiency appears to play a substantial role in the pathogenesis of impotence in transplant patients. Anastomosis of the graft to external iliac artery could preserve the potency to some degree. Antihypertensives should be reduced as much as possible to avoid their negative effects on erectile function.

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Section: Discussioncontrasting

confidence: 58%

“…1,2 The etiology of erectile dysfunction in transplant recipients is often multifactorial. Vascular insufficiency as a cause of impotence in renal transplant recipients (RTR) has received limited attention.…”

Section: Introductionmentioning

confidence: 99%

Role of penile vascular insufficiency in erectile dysfunction in renal transplant recipients

et al. 2002

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“…Fatigue and psychosocial factors related to the presence of a chronic disease are also contributory factors. 7 In a cross-sectional study in 323 kidney transplant patients, 8 authors found that factors significantly and negatively related to ED were: age, time on dialysis, and iterative transplants. There is not a lot of information about ED of renal transplant bearers, but among the risk factors are underlying vascular factors, hypogonadism associated with immunosuppressive doses of steroids, and neurogenic factors associated with the main diagnosis (eg diabetes).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with erectile dysfunction in male kidney transplant recipients

et al. 2003

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A transversal study was carried out in order to evaluate the prevalence of erectile dysfunction (ED) in adult kidney transplant patients of our region (N ¼ 243), and to investigate the sociodemographic, analytic, and clinical factors associated with it. To evaluate ED, the Spanish five items version of the International Index of Erectile Function (IIEF-5) was employed. Sociodemographic, analytic, and clinical data, including 12 cardiovascular risk factors, were also collected. A total of 199 patients (82%) were included. The median age was 52 y (43-62 y); 106 patients (54.9%) presented with ED. Variables associated with ED were: higher age; longer time on dialysis prior to transplantation; higher comorbidity; presence of diabetes mellitus; had undergone prostatic surgery or peripheric artheriopathy; lower diastolic pressure; and some anti hypertensive drugs. Logistic Regression Model performed step by step showed (R 2 ¼ 0.52) that factors independently associated with ED were: age, time on dialysis previous to transplant, and peripheric artheriopathy.

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“…While several studies have suggested that erectile function significantly improves after successful renal transplantation, [5][6][7][8] especially when the surgery is performed at a younger age, 5 other studies have shown minimal effects of transplantation on erectile performance or even deterioration. [9][10][11][12] The overall prevalence of ED after KT remains high, ranging from 48.9% 13 to 55.7%. 11 The potential causative effects of ED in transplant recipients may include anxiety, medication side effects, impaired penile vascularity and failure to resolve hormonal abnormalities or underlying disease comorbidities.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12] The overall prevalence of ED after KT remains high, ranging from 48.9% 13 to 55.7%. 11 The potential causative effects of ED in transplant recipients may include anxiety, medication side effects, impaired penile vascularity and failure to resolve hormonal abnormalities or underlying disease comorbidities. 14 Reduced cavernosal arterial inflow was hypothesized as the likely cause of ED in a series in which the internal iliac artery was employed for end-to-end anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?

Gontero

Oderda²,

Filippini³

et al. 2011

Asian J Androl

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Reduced cavernosal arterial inflow has been hypothesized to be the likely cause of erectile dysfunction after kidney transplants in recipients revascularized through end-to-end anastomosis to the internal iliac artery, suggesting that end-to-side anastomosis at the external iliac artery is preferable. The aim of this study was to prospectively evaluate the effect of the use of the external iliac artery on erectile function, hormone profiles and penile blood flow by evaluating changes in penile colour Doppler ultrasound parameters in a consecutive series of 22 recipients before and after end-to-side external iliac artery transplantation. The mean International Index of Erectile Function-Erectile Function (IIEF-EF) domain score decreased significantly 3 months after transplant (18.0966.33 vs. 22.5067.09, P50.01). The reduction in peak systolic velocity (PSV) was significant for the cavernous artery homolateral to the side of transplant (42.60618.77 vs. 52.01619.91, P50.01). The mean postoperative end diastolic velocity (EDV) did not differ significantly from the preoperative value (P50.74). No statistical differences were found in the serum levels of testosterone or prolactin. Kidney grafts anastomosed at the external iliac artery produced significant (P50.01) reductions in arterial inflow at the homolateral cavernosal artery that remained above the normal threshold. Whether these haemodynamic changes can explain the worsening of postoperative erectile function remains to be proven.

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High Prevalence of Erectile Dysfunction After Renal Transplantation

Abstract: IIEF proved to be a valuable means of unveiling highly prevalent erectile dysfunction in male kidney transplant recipients. The negative impact of the time on dialysis was emphasized in the results.

Cited by 91 publications

References 13 publications

Role of penile vascular insufficiency in erectile dysfunction in renal transplant recipients

Role of penile vascular insufficiency in erectile dysfunction in renal transplant recipients

Factors associated with erectile dysfunction in male kidney transplant recipients

Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?

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