Impact of Kidney Transplantation on Male Sexual Function: Results from a Ten-Year Retrospective Study

Abstract

Background The effects of kidney transplantation on male sexual function are controversial. Aim To evaluate the impact of kidney transplantation on erectile and ejaculatory function and to assess a possible correlation between some selected characteristics of patients and their erectile and ejaculatory function after renal transplantation. Methods An observational retrospective analysis was conducted on male patients who had undergone kidney transplantation from January 2009 to April 2019. A prospectively maintained database was used to collect all data. Patients were evaluated before kidney transplant and 6 and 12 months after kidney transplant. Male patients undergoing renal transplantation for any cause who were sexually active with a stable partner were included in the study. Outcomes The main outcome measures included the International Index of Erectile Function (IIEF-15) and the 4-item version of Male Sexual Health Quality–Ejaculation Disorders (MSHQ-EjD Short Form) questionnaires. The first 3 questions of the MSHQ-EjD Short Form were used to assess the ejaculatory function, whereas the fourth question was used to evaluate the ejaculation bother. Results A total of 95 patients were eligible in the study. The evaluation of sexual function was available in 56 patients (58.9%). Mean IIEF-15 significantly decreased at 6 months (P < .001) remaining unchanged at 12 months (P = .228). Mean MSHQ-EjD Short Form (1–3) significantly decreased at 6-month follow-up (P < .001) and at 12-month follow-up (P = .024). Mean MSHQ-EjD Short Form (4) was significantly increased compared with the baseline at both 6 and 12 months (P < .05). IIEF-15 was significantly related to the MSHQ-EjD Short Form at 6-month and 12-month follow-up (P < .001). Age, diabetes, hypertension, smoking, pretransplantation testosterone, time for transplantation, baseline IIEF-15, and baseline MSHQ-EjD Short Form (1–3) were significantly associated (P < .05) with both IIEF-15 and the MSHQ-EjD Short Form (1–3) at 6-month and 12-month follow-up after kidney transplantation. Clinical Implications Improvement of knowledge regarding the effects of kidney transplantation on sexual function and about the patient characteristics related to sexual health after transplantation. Strength & Limitations This is the first article that analyzes in depth the ejaculatory function in patients who had undergone kidney transplantation assessing ejaculation with a validated questionnaire. The main limitation is the retrospective design of the study. Conclusion Kidney transplantation appears to have a negative impact on sexual health, significantly worsening both erectile and ejaculatory functions. Age, diabetes, hypertension, smoking, pretransplantation testosterone levels, time for transplantation, as well as erectile and ejaculatory function before transplant were significantly related to erectile and ejaculatory functions after renal transplantation.

Sexual dysfunction and activity avoidance in female kidney transplant patients

“…Many studies on sexual dysfunction in kidney transplant patients have focused on males. [25][26][27] Our study, to the best of our knowledge, is the first to show that post-transplant time and activity avoidance are associated with sexual dysfunction in female kidney transplant patients, which provides a theoretical basis for improving the sexual quality of life of those populations.…”

“…This association was observed in Spirito's study for male kidney transplant patients, 27 indicating that healthcare workers should also provide sex-related guidance in the early period of transplantation, in addition to focusing on allograft kidney function. Our study also showed that smoking (active and passive) was strongly associated with FSD in kidney transplant patients.…”

“…At present, the etiology of SD in kidney transplant patients remains unclear and may be caused by physiological factors (eg, drug side effects, comorbidities, hormone disturbances, autonomic neuropathy) or psychological factors, 24 and the majority of studies on sexual dysfunction in kidney transplant patients have focused on male patients. [25][26][27] Our current study's objectives were to assess sexual dysfunction in female kidney transplant patients and the relationship among sexual function, activity avoidance, and kidney function to further elucidate the mechanism of female sexual dysfunction after transplantation. We also analyzed the relationships between some sociodemographic and clinical variables and sexual function.…”

Sexuality, Contraception, and Pregnancy in Kidney Transplantation

“…Previous studies have shown improvement in erectile dysfunction after kidney transplantation 14 , 15 but a recent study looked at both erectile and ejaculatory function prospectively in kidney transplant recipients. 16 The mean IIEF score significantly decreased at 6 months and was unchanged at 12 months after transplantation. Ejaculatory function, as assessed by the Male Sexual Health Quality-Ejaculation Disorders (MSHQ-EjD) short form, also decreased significantly at the 6- and 12-month follow-up.…”

Renal Transplantation Improves Erectile Function in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

“…9 Epidemiological data and relevant nonsystematic, qualitative reviews do not comprehensively address this matter and render the effect of RT on EF controversial. 10,11 Within this framework, we systematically synthesized the available evidence and generated a meta-analysis, aiming to assess the effect of renal transplantation on erectile function and to determine potential factors improving or deteriorating erectile dysfunction.…”