Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey

Tian, Ye; Ji, Zhengguo; Tang, Yinshan; Zhang, Lei; Wen-cheng, LU; Lin, Jun; H, Guo; Xie, Zelin; Sun, Wen; Du, Liqing; J, Ao; Ma, Linlin; Chen, Lisheng; Xu, Yuancheng

doi:10.1097/00029330-200805010-00009

Cited by 18 publications

(23 citation statements)

References 21 publications

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“…Earlier reports have associated ED with retinoid use [13,34,35], showing a direct action on the male reproductive system in animal models [36,37]. Among male renal transplant recipients, those receiving cyclosporine-based immunosuppressive regimens are more likely to have ED [38]. In our study, the risk of SD was not significantly elevated in patients receiving systemic treatment, including retinoid, methotrexate, and cyclosporine.…”

Section: Discussionsupporting

confidence: 49%

Increased Risk of Sexual Dysfunction in Male Patients with Psoriasis: A Nationwide Population-Based Follow-Up Study

Chen

Lin³

et al. 2013

The Journal of Sexual Medicine

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Introduction An association between psoriasis and sexual dysfunction (SD) has been explored. However, the risk of SD after the diagnosis of psoriasis relative to the age-matched general population remains unknown. Aim To clarify the risk of developing SD in male patients with psoriasis. Methods From 2000 to 2001, we identified 12,300 male patients with newly diagnosed psoriasis and 61,500 matching controls from National Health Insurance Database in Taiwan. Main Outcome Measures The two cohorts were followed up until 2008, and we observed the occurrence of SD by registry of SD diagnosis in the database. Stratified Cox proportional hazard regressions were used to calculate the 7-year SD risk for these two groups. Results Of the 73,800 sampled patients, 1,812 patients (2.46%) experienced SD during the 7-year follow-up period, including 373 (3.03% of patients with psoriasis) in the study group and 1,439 (2.34% of patients without psoriasis) in the comparison group. The hazard ratio (HR) for SD for patients with psoriasis was 1.27 times (95% confidence interval [CI], 1.11–1.46; P = 0.001) as high as that for patients without psoriasis after adjusting for age, monthly income, number of health-care visits, systemic treatment, and other comorbidities. Stratified analysis showed that the risk of SD was higher in patients older than 60 years old (HR: 1.42, 95% CI: 1.12–1.81) and patients with psoriatic arthritis (HR: 1.78, 95% CI: 1.08–2.91). However, the risk of SD was not significantly elevated in patients receiving systemic treatment, including retinoid, methotrexate, and cyclosporine. Conclusions Male patients with psoriasis are at increased risk of developing SD. Physicians should pay attention to the impact of psoriasis on psychosocial and sexual health, especially in old-aged patients.

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Section: Discussionsupporting

confidence: 49%

Increased Risk of Sexual Dysfunction in Male Patients with Psoriasis: A Nationwide Population-Based Follow-Up Study

Chen

Lin³

et al. 2013

The Journal of Sexual Medicine

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“…La prévalence du DE au cours de l'IRC est estimée aux alentours de 49-55 % par la plupart des auteurs [5][6][7][8][9]. Plusieurs facteurs ont été incriminés : les désordres métaboliques, hormonaux et psychologiques [10,11].…”

Section: Discussionunclassified

“…Bien que nous n'ayons pas trouvé de différence statistiquement significative dans notre étude (Tableau 4), une augmentation de la prévalence et de la sévérité du dysfonctionnement sexuel avec l'âge et la durée d'hémodialyse a été rapportée [6,7]. Paradoxalement, un taux significativement plus élevé (p < 0,05) de la créatininémie a été noté chez un groupe de patients qui ont une activité sexuelle supérieure à cinq fois par mois.…”

Section: Discussionunclassified

“…Pour certains, la revascularisation du transplant rénal pourrait aggraver l'insuffisance vasculaire pénienne [7,9,12] et ne restaure pas la qualité spermatique [6]. D'autres études [1,5] ont rapporté une amélioration significative de la FE et même des paramètres spermatiques surtout chez les patients jeunes de moins de 45 ans.…”

Section: Tableau 3 Valeurs Moyennes (± éCart-type) De La Fsh Et De Launclassified

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Analyse du statut spermatique, érectile et hormonal chez des patients hémodialysés

Ajina

Zaouali²,

Loussaief

et al. 2011

Basic Clin. Androl.

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But : Le but de notre travail était d'établir le profil hormonal, érectile et spermatique chez les patients hémodia-lysés et de rechercher l'impact des perturbations hormonales sur la fonction érectile (FE) et les paramètres spermatiques. Patients et méthodes : Nous avons réalisé une étude transversale chez 30 sujets hémodialysés chez qui un spermogramme a été réalisé parallèlement à un bilan hormonal qui incluait le dosage sérique de FSH (follicle-stimulating hormone) et la testostérone totale. La FE a été évaluée par l'étude de l'indice international de la FE dans sa version française (IIEF-5). Le dosage des hormones sexuelles a été fait par la technique radio-immunologique, et la pratique du spermogramme a été faite selon les recommandations de l'OMS. Résultats : Deux patients seulement avaient un spermogramme et un bilan hormonal normaux, l'IIEF était normal chez un seul patient.Les patients azoospermiques (16 %) présentaient un eugonadisme hypergonadotrophique. Quarante pour cent des patients avaient une hypospermie. Un tiers des patients présentait une oligozoospermie sévère associée à un taux élevé de FSH dans 77 % des cas.La mobilité et la morphologie spermatique étaient altérées dans respectivement 96 et 50 % des cas. Le bilan hormonal montrait une élévation de la FSH (> 8,5 mUI/ml) chez 40 % des patients, et la testostéronémie était diminuée (< 3,2 ng/ml) chez 25 % des patients. Deux patients présentaient un hypogonadisme franc (testostérone < 2 ng /ml). Discussion : Le volume de sperme était diminué de façon significative chez les patients de plus de 30 ans. La FE était perturbée dans 73 % des cas avec un IIEF moyen de 15 (IIEF normal > 20). Plusieurs auteurs ont mis en évidence une corrélation entre le dysfonctionnement gonadique et les taux élevés de gonadotrophines chez l'homme présentant une insuffisance rénale chronique, avec ou sans atrophie testiculaire. Dans notre série, la testostéronémie était normale chez nos patients malgré l'absence de prise d'androgène. Les séances d'hémodialyses permettent-elles de préserver la fonction endocrine des testicules ? Conclusion : Les patients au stade d'hémodialyse chronique d'une durée supérieure à un an présentaient un eugonadisme hypergonadotrophique ainsi qu'une insuffisance érectile. L'ancienneté de l'hémodialyse n'altère pas de manière significative les paramètres spermatiques ni la FE. Les patients d'un âge supérieur à 30 ans présentaient une diminution significative du volume spermatique qui pourrait être un marqueur déterminant de l'atteinte de la FE et de la fonction reproductive. Pour citer cette revue : Androl. 21 (2011).Abstract Introduction: Our work was to establish the hormonal, semen and erectile profile among haemodialysed patients and to seek the impact of hormonal disturbances on erectile function and semen parameters. Patients and methods: We conducted a cross-sectional study in haemodialysed patients in whom a semen, in parallel with hormonal analyses including FSH (follicle stimulating hormone) and testosterone. Erectile function was a...

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“…ED appears to associate more clearly with diabetes mellitus in renally impaired patients ; however, it should be noted that patients with this comorbidity have been excluded from some analyses . Similarly, immunosuppression with cyclosporin A has been associated with ED in some , but not all , studies.…”

Section: Introductionmentioning

confidence: 99%

Phosphodiesterase Type 5 Inhibitor Treatment for Erectile Dysfunction in Patients with End-Stage Renal Disease Receiving Dialysis or After Renal Transplantation

Lasaponara¹,

Sedigh²,

Pasquale

et al. 2013

The Journal of Sexual Medicine

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Introduction The phosphodiesterase type 5 (PDE5) inhibitors are generally well tolerated and effective for treating erectile dysfunction (ED), including in patients with significant comorbidity. Because of this benign safety profile, investigators have used PDE5 inhibitors to treat patients with ED and severe renal disease or those who have received renal transplants. Aim To assess safety and efficacy of PDE5 inhibitors in patients receiving dialysis or renal transplants. Main Outcome Measures Erectile function as assessed by the International Index of Erectile Function (IIEF) and Global Assessment Questions; adverse events (AEs). Methods We reviewed published studies of PDE5 inhibitors in patients receiving dialysis or renal transplants. Results In double-blind, placebo-controlled studies in patients receiving dialysis or renal transplants, sildenafil significantly improved erectile function as assessed by the IIEF, and 75–85% of patients reported improved erectile function on Global Assessment Questions; efficacy was more variable in less well-controlled studies. In >260 patients undergoing dialysis who received sildenafil in clinical studies, there were only six reported discontinuations because of AEs (headache [N=3], headache and nausea [N=1], gastrointestinal [N=1], and symptomatic blood pressure decrease [N=1]). In approximately 400 patients with renal transplants who received sildenafil, only three patients discontinued because of AEs. Vardenafil improved IIEF scores of up to 82% of renal transplant recipients in randomized, controlled studies (N=59, total), with no reported discontinuations because of AEs. Limited data also suggest benefit with tadalafil. Conclusions ED is common in patients undergoing renal dialysis or postrenal transplant and substantially affects patient quality of life. Sildenafil and vardenafil appear to be efficacious and well tolerated in patients receiving renal dialysis or transplant.

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Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey

Cited by 18 publications

References 21 publications

Increased Risk of Sexual Dysfunction in Male Patients with Psoriasis: A Nationwide Population-Based Follow-Up Study

Increased Risk of Sexual Dysfunction in Male Patients with Psoriasis: A Nationwide Population-Based Follow-Up Study

Analyse du statut spermatique, érectile et hormonal chez des patients hémodialysés

Phosphodiesterase Type 5 Inhibitor Treatment for Erectile Dysfunction in Patients with End-Stage Renal Disease Receiving Dialysis or After Renal Transplantation

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