Renal Transplantation Does Not Improve Erectile Function in Hemodialysed Patients

Background: Effects of renal transplantation (RT) on erectile dysfunction (ED) is a controversial issue. Objective: To verify the efficacy of RT in restoring erectile function (EF) in hemodialysed patients. Design, setting, and participants: We conducted a prospective, interventional, nonrandomised study from September 2001 to September 2005 on 78 hemodialysed male patients undergoing RT. EF was evaluated during the baseline visit and 1 yr after RT, using the International Index of Erectile Function (IIEF) questionnaire. A subanalysis was performed by splitting the total cohort into two age groups: <45 yr and >= 45 yr. Intervention: RT was performed. Measurements: EF was evaluated using the IIEF scoring system. Results and limitations: Before RT, 68 patients with a mean total IIEF score of 42.46 complained about ED. One year after RT, 71 patients reported ED, and the mean total IIEF score had decreased to 39.97. The mean pre-RT IIEF EF domain score was 18.48, and it decreased to 17.55 after RT. Patients aged >= 45 yr reported no significant variations in any IIEF domain, while patients aged <45 yr reported a significant decrease in mean total IIEF score due to variations in domain scores for erectile function, sexual desire, and overall satisfaction. In the younger age group, we found significant differences between baseline and post-RT IIEF scores in dyslipidaemic patients and in those patients using immunosuppressive (methylprednisolone and cyclosporin) or antihypertensive (ACE-inhibitors, beta-blockers, and Ca-antagonists) drugs. The main limitations were the absence of any aetiological characterisation of ED and the small number of patients. Conclusions: After RT, EF worsens in patients <45 yr but is not modified in patients >= 45 yr. (C) 2008 European Association of Urology. Published by Elsevier B. V. All rights reserved.