Male sexual dysfunction in patients with chronic end-stage renal insufficiency and in renal transplant recipients

Abstract

The ED in patients with end stage chronic kidney failure (CKF) continues to have a strong prevalence, either in the patients who are undergoing dialysis or in those who have received transplants. In literature this issue is not sufficiently considered if not at all. Hypotestosteronemia is a risk factor for the onset of ED in end stage CKF patients. A significantly lower prevalence of hypogonadism among dialyzed patents and transplant recipients suggests that renal transplantation may be protective for the sexual capabilities of these patients.

Sexual function of kidney transplant recipients

“…In this sample, 29 kidney transplant recipients reported no sexual activity in the previous 4 weeks (20.9%), which is consistent with other studies, although lower than the percentage (35%) found by Antonucci et al (2015) in male individuals. It is thus important to identify the reason behind the lack of sexual activity for a long period of time.…”

“…ESRD also has a strong impact on the sexual functioning of both men and women, clearly affecting their quality of life (Raggi et al, 2012) and leading to sexual dysfunction, which is a very common, benign, underdiagnosed, and multifactorial condition. Its risk factors (both physiological and psychological) are similar for both men and women (Antonucci et al, 2015). Some studies show that kidney transplantation improves sexual functioning by correcting metabolic and endocrine imbalances and improving psychological problems (Filocamo et al, 2009).…”

“…Tomada and Tomada (2012) believe that it refers to a change occurring during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. A number of studies have identified the etiology of sexual dysfunction as being multifactorial (Antonucci et al, 2015;Wespes et al, 2013). Cardiovascular diseases (sedentary lifestyle, obesity, smoking, high cholesterol, and metabolic syndrome), anxiety, and depression are among the most common risk factors.…”

“…Factors contributing to sexual dysfunction in kidney transplant recipients include age, hypertension, diabetes mellitus, malnutrition, smoking, endocrine disturbances, anemia, neuropathy, drug therapy, time of hemodialysis (HD), being a second-time transplant recipient, self-esteem problems (concerning body image, and interpersonal roles and relationships), fatigue and weakness, lack of intimacy and loss of sexual desire, depression, and fear (Antonucci et al, 2015;Branco et al, 2013;Mirone et al, 2009). Research on sexual dysfunction in kidney transplant recipients has focused on men, mostly on erectile dysfunction, concluding that: there is a higher prevalence of erectile dysfunction in patients undergoing HD than in transplant recipients (Antonucci et al, 2015); the prevalence of erectile dysfunction is higher among transplant recipients under the age of 45 years (Mirone et al, 2009), a result which is contrary to the study by Antonucci et al 2015where being older than 50 years and having diabetes mellitus and hypotestosteronemia are associated with erectile dysfunction; the prevalence of erectile dysfunction is lower in living-donor transplant recipients than in cadaveric-donor transplant recipients due to minimized ischemic injury, lower immunosuppressive treatment dosages, and improved graft outcomes (Branco et al, 2013). Studies with women have concluded that sexual dysfunction decreased after kidney transplantation; successful renal transplantation may improve depression (Kettas, Çayan, Efesoy, Akbay, & Çayan, 2010); sexual dysfunction is high (Küçük et al, 2013); renal transplantation has positive effects on sexual function and menstrual and hormonal status.…”

Erectile Dysfunction in Hemodialysis in Togo

“…This is as a result of a difficulty or an interpersonal difficulty [1]. Many studies have been carried throughout the world on erectile dysfunction in the USA [2], in Italy [3] [4] and in France [5] [6] [7]. It occurs more and more in the general population but is pronounced in some individuals like those with chronic kidney diseases [7].…”