Sexual dysfunction after renal replacement therapy

Diemont, W.L.; Vruggink, P.A.; Meuleman, E.J.H.; Doesburg, W.H.; Lemmens, W.A.J.G.; Berden, Jo H. M.

doi:10.1016/s0272-6386(00)70254-x

Cited by 139 publications

(93 citation statements)

References 12 publications

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“…6 Thus, the perception of the individual determines whether a problem exists in a particular dimension of sexual functioning. 7 Twentyfour percent of the patients in this study perceived that they suffered from sexual problems before transplantation, and this perception persisted in 15% after transplantation.…”

Section: Discussionmentioning

confidence: 99%

Sexual health after orthotopic liver transplantation

Schaeffer

et al. 2006

Liver Transpl

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Many studies have reported improved health-related quality of life outcomes after orthotopic liver transplantation; however, specific research regarding sexual health in liver transplant recipients is limited. We surveyed liver transplant recipients to determine the prevalence of sexual dysfunction. Of the 320 adult liver transplant recipients surveyed by mailed questionnaire, 150 responded (42%). The median age was 54 years. A total of 62% of respondents were male, and 93% were at least 1 year after transplantation. Thirty-six respondents (24%) reported sexual dysfunction before transplantation; this persisted in 22 patients (15%) after transplantation. A total of 48 respondents (32%) reported de novo sexual dysfunction after transplantation. After transplantation, 23% of male and 26% of female respondents reported decreased libido, and 33% of men and 26% of women reported having difficulty reaching orgasm with intercourse. A total of 42% of respondents felt that immunosuppressive medication was the main contributing factor to their sexual problems: 33% and 35% of respondents receiving tacrolimus or cyclosporine monotherapy, respectively, experienced some degree of sexual problems after transplantation. Despite the reported sexual problems, 59% of respondents were "moderately" to "very satisfied" with their sexual relationships after transplantation. Nineteen percent of the respondents used sildenafil to improve their sexual function, and 65% of these reported benefit. In conclusion, sexual problem after orthotopic liver transplantation is a common but poorly studied problem. Although this single-center study has shed some light on the relationship between liver transplantation and sexual health, further prospective studies, involving larger study population and validated instruments, will be needed to better evaluate the influence of liver transplantation on recipients' sexual health. During the past 20 years, orthotopic liver transplantation has emerged as the treatment of choice for endstage liver diseases of various causes. Most transplant centers reported 1-year survival rates for adult transplant recipients of about 80-90% and 9-year survival rates of 55%. 1 As the clinical outcomes of orthotopic liver transplantation continue to improve, resulting in fewer postoperative complications and better immunosuppression, other outcomes, such as health-related quality of life, become important targets of evaluation. Although considerable research has been conducted on the morbidity and mortality of orthotopic liver transplantation, less is known about the influence of orthotopic liver transplantation on health-related quality of life of the transplant recipients. In particular, literature on sexual health for this population is limited.Sexual health encompasses not only sexual function, but also involves the full range of human experience. Sexuality allows communication of emotional feelings, provides a means of physical pleasure and gratification, enhances feelings of self-worth, and strengthens relationships. 2...

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Section: Discussionmentioning

confidence: 99%

Sexual health after orthotopic liver transplantation

Schaeffer

et al. 2006

Liver Transpl

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“…Since both groups had impaired renal function, this state-of-affairs may have had a confounding effect in our study. Uremia may impair gonadal steroidogenesis; however, the groups were matched for renal function, and creatinine concentrations had no significant effect in the multiple regression analysis (10). Perhaps the effect of sirolimus on the testes is somehow more pronounced in persons with reduced renal function.…”

Section: Sirolimus and Testosteronementioning

confidence: 99%

Testosterone Concentrations and Sirolimus in Male Renal Transplant Patients

Fritsche

Budde

Dragun

et al. 2004

American Journal of Transplantation

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Sirolimus damages the testes in animals; however, human data are sparse. We conducted a case-control study to obtain further insight into this issue and compared testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin concentrations in matched renal transplant patients who did or did not receive sirolimus. We found that testosterone values were lower (11.2 ± ± 6.3 nmol/L vs. 15.5 ± ± 7.7 nmol/L, p < 0.05), in 28 sirolimus-treated patients, compared to 28 non-sirolimus-treated controls. Furthermore, these patients more commonly had testosterone concentrations that were below our reference value for normal men. In contrast, FSH and LH concentrations were higher while prolactin levels were not different. These data are consistent with sirolimusrelated testosterone suppression and suggest a need for further studies.

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“…[1][2][3][4] More than half of the patients receiving dialysis treatment describe SD, most commonly a loss of interest in sexual activity. 1,4 A questionnaire given to dialysis patients revealed that 65% were dissatisfied with sex since starting dialysis, 40% have stopped having sex, 27% have no desire for sex and 23% reported they could not achieve orgasm. 2 Although sexuality was the fifth most important life stressor cited by dialysis patients, 2 SD receives very limited attention in the follow-up of dialysis patients.…”

Section: Introductionmentioning

confidence: 99%

The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis

Soykan

2004

Int J Impot Res

178

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TurkeyAlthough sexuality was the fifth most important life stressor cited by dialysis patients, sexual dysfunctions (SD) receive a very limited attention in the follow-up of these patients. The main aim of the present study was to investigate the reliability and validity of the Arizona Sexual Experiences Scale (ASEX) for end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) in Turkey. The instrument's reliability and validity were assessed in 43 ESRD outpatients undergoing dialysis. All patients were assessed at baseline and at 6 months. ASEX showed good internal consistency (Cronbach's a's 0.89 and 0.90) and test-retest reliability (r ¼ 0.88, Po0.001). Convergent validity of ASEX was measured by means of the scales' correlation with the psychiatrists' assessment for the presence of SD (r ¼ 0.53, Po0.001). The results of receiver operating characteristics analysis for criterion validity revealed that ASEX scores could discriminate well (0.8570.06 (95% confidence interval, 0.73-0.90), Po0.001) between patients with 'no SD (n ¼ 26)' and 'with SD (n ¼ 17)'. A total ASEX score of r11 was found to be the best cutoff point (sensitivity ¼ 100%, specificity ¼ 52%) for screening in this group of patients. The findings of this study indicate that the ASEX is a valid and reliable instrument for use in clinical trials on sexual functioning of ESRD patients undergoing HD.

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Sexual dysfunction after renal replacement therapy

Cited by 139 publications

References 12 publications

Sexual health after orthotopic liver transplantation

Sexual health after orthotopic liver transplantation

Testosterone Concentrations and Sirolimus in Male Renal Transplant Patients

The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis

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