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[Studies on sexual dysfunction in male patients with chronic renal insufficiency]
Wei-Dong Zhang1, Jun-Ming Fan, Jing Guan
1Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Objectives:
To investigate the prevalence, main manifestation and related factors of sexual dysfunction in male patients with chronic renal insufficiency (CRI).
Methods:
A cross-section study was conducted by six hospitals in Sichuan Province. The prevalence and severity of sexual dysfunction were assessed by SCASF microsoft among patients with chronic renal disease. Logistic regression was used to examine and test the association between sexual dysfunction and other medical conditions.
Results:
The prevalence of sexual dysfunction was wider in patients with CRI than in those without. The main manifestations in male patients were decreased libido, erectile dysfunction and premature ejaculation. Stratified analysis in uremia showed that the prevalence and severity of sexual dysfunction were similar between patients on haemodialysis(HD) and those on peritoneal dialysis(PD). The patients receiving no replacement treatment suffered more decreased libido and performance anxiety than dialyzed patients (HD and PD) and transplantation patients(Tx). The patients receiving no replacement treatment and dialysis suffered more erectile dysfunction than Tx men. A multivariable analysis demonstrated that the duration, creatinine clearance(Ccr), parathyroid hormone (PTH), albumin(Alb) were not associated with sexual dysfunction. The use of beta-blocker, anemia and depression were risky factors for decreased libido, and increasing age was a risky factor for erectile dysfunction. The use of angiotensin-converting-enzyme inhibitor(ACEI)/angiotention receptor antagonist (ARB) and recombinant human erythropoietin(r-HuEpo) were protective factors for erectile dysfunction.
Conclusions:
The main manifestations of sexual dysfunction in male patients with CRI are decreased libido, erectile dysfunction and premature ejaculation. The replacement therapy, especially transplantation, can decrease the prevalence or severity of sexual dysfunction. The genesis of sexual dysfunction is multifactorial, including age, physiological factors, psychological factors and medical conditions.
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