Introduction: Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient to allow satisfactory sexual performance. In end-stage renal disease (ESRD), ED is an important problem that impairs quality of life. The incidence of ED may increase up to 84%, especially in ESRD patients receiving hemodialysis. Our aim is to determine the effect of renal transplantation on erectile functions in ESRD patients and patient-related factors affecting this change.
Methods: Data of patients with ESRD who had a renal transplant at our center from January 2015 to August 2020 were reviewed retrospectively. All male patients who had a kidney transplant for any reason and whose data were not missing were included. The patients were screened for erectile functions before kidney transplantation and at the 1st, 3rd and 12th months after transplantation. The International Index of Erectile Function (IIEF-5) evaluation questionnaire was used as a measure of erectile functions. The total scores were calculated, with normal erectile function defined as a score of 22 to 25; cases of ED were classified as mild (12–21), moderate (8–11), or severe (5–7).
Results: The mean age of 55 patients included in the study was 39.7 ± 10.9 years. Mild ED was detected in 21 patients (38.2%), moderate ED in 19 patients (34.5%), and severe ED in 10 patients (18.2%). Preoperative mean IEFF-5 score was calculated as 13.8 ± 5.5, 14.3 ± 5.7 at 1st month, 16.9 ± 6.8 at 3rd months, and 18.4 ± 6.9 at 12th months. In the evaluation of erectile function, no significant improvement was observed in erectile functions at post-transplant 1st month (p>0.05), while significant improvements were noted at postoperative 3rd and 12th months (p=0.03, p=0.02, respectively). When the change in IEFF-5 score was evaluated between 3rd and 12th months, there was a statistically significant difference (p=0.04). Age, diabetes, hypertension, coronary artery disease, transplantation time and preoperative IEFF-5 score were found to be significantly associated with postoperative IEFF-5 score changes at the 3rd and 12th months. (p < 0.05)
Conclusions: Our data show that kidney transplantation improves erectile function in ESRD patients. Age, diabetes, hypertension, coronary artery disease, transplantation time and pre-transplant erectile function status were found to be significantly associated with postoperative erectile function changes.
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