Critical evaluation of the factors influencing erectile function
Critical evaluation of the factors influencing erectile function
A total of 400 male renal transplant recipients (RTR) were investigated. Data on medical, sexual history, clinical examination and laboratory variables were collected. The severity of erectile dysfunction (ED) was assessed using the International Index of Erectile Function questionnaire. Univariate and multivariate logistic regression analyses were used to determine prognostic variables, which have independent impact on erectile function. ED was detected in 35.8% of the whole group. Current erectile function as compared to pretransplant status was improved, deteriorated or remained static in 44, 12.5 and 43.5% of the evaluated transplant recipients, respectively. After logistic regression analysis, age, hemoglobin level and presence of DM and/or peripheral neuropathy had significant and independent negative impact on erectile function. We concluded that renal transplantation has varying effects on erectile function. ED is highly prevalent among RTR and its pathogenesis is multifactorial.
Chronic renal failure (CRF) has been frequently associated with erectile dysfunction (ED), the incidence is variable between 20 and 60%. As a result of the multisystem disease processes present in many uremic men, it is apparent that the pathogenesis of ED is most probably multifactorial. Factors to be considered include peripheral vascular disease, neurogenic abnormalities, hormonal disturbances and medications used for treatment of conditions associated with CRF. These physiological abnormalities may be supplemented by significant psychological stresses and abnormalities resulting from chronic illness and generalized changes in body function.
Erectile function usually improves after successful renal transplantation. Salvatierra et al found that 84% of patients with stable renal transplantation function for 3 or more years regained the same level of sexual activity that they had experienced before the onset of uremia. Flechner et al analyzed 23 males with renal allograft survival longer than 10 y and found a renewed and heightened interest in sexual activity in all the evaluated patients. The improvement in erectile function may be due to normalization of metabolic and hormonal functions and improvement of psychological problems of hemodialyzed patients after transplantation.
However, several male patients may continue to experience ED in spite of successful renal transplantation. Recent studies showed that 48-56% of renal transplant recipients (RTR) continue to have ED. The ED in RTR is often multifactorial, since pharmacological, endocrine, neurogenic, vascular and psychogenic causes seem to be implicated. For some patients, this procedure has no effect whatsoever on erectile function. The reported literatures about the factors associated with ED after renal transplantation were either old or have been conducted on a limited number and in most of these studies a univariate analysis was only utilized.We have evaluated male RTR at our center to determine the impact of renal transplantation on erectile function and to define the causes and prevalence of ED post-transplant.
A total of 400 male renal transplant recipients (RTR) were investigated. Data on medical, sexual history, clinical examination and laboratory variables were collected. The severity of erectile dysfunction (ED) was assessed using the International Index of Erectile Function questionnaire. Univariate and multivariate logistic regression analyses were used to determine prognostic variables, which have independent impact on erectile function. ED was detected in 35.8% of the whole group. Current erectile function as compared to pretransplant status was improved, deteriorated or remained static in 44, 12.5 and 43.5% of the evaluated transplant recipients, respectively. After logistic regression analysis, age, hemoglobin level and presence of DM and/or peripheral neuropathy had significant and independent negative impact on erectile function. We concluded that renal transplantation has varying effects on erectile function. ED is highly prevalent among RTR and its pathogenesis is multifactorial.
Chronic renal failure (CRF) has been frequently associated with erectile dysfunction (ED), the incidence is variable between 20 and 60%. As a result of the multisystem disease processes present in many uremic men, it is apparent that the pathogenesis of ED is most probably multifactorial. Factors to be considered include peripheral vascular disease, neurogenic abnormalities, hormonal disturbances and medications used for treatment of conditions associated with CRF. These physiological abnormalities may be supplemented by significant psychological stresses and abnormalities resulting from chronic illness and generalized changes in body function.
Erectile function usually improves after successful renal transplantation. Salvatierra et al found that 84% of patients with stable renal transplantation function for 3 or more years regained the same level of sexual activity that they had experienced before the onset of uremia. Flechner et al analyzed 23 males with renal allograft survival longer than 10 y and found a renewed and heightened interest in sexual activity in all the evaluated patients. The improvement in erectile function may be due to normalization of metabolic and hormonal functions and improvement of psychological problems of hemodialyzed patients after transplantation.
However, several male patients may continue to experience ED in spite of successful renal transplantation. Recent studies showed that 48-56% of renal transplant recipients (RTR) continue to have ED. The ED in RTR is often multifactorial, since pharmacological, endocrine, neurogenic, vascular and psychogenic causes seem to be implicated. For some patients, this procedure has no effect whatsoever on erectile function. The reported literatures about the factors associated with ED after renal transplantation were either old or have been conducted on a limited number and in most of these studies a univariate analysis was only utilized.We have evaluated male RTR at our center to determine the impact of renal transplantation on erectile function and to define the causes and prevalence of ED post-transplant.