Improvement of erectile dysfunction after kidney transplantation: the role of the associated factors

The aim of this study was to evaluate erectile dysfunction (ED) in hemodialysis patients and the factors influencing ED after a successful kidney transplantation.

A total of 64 patients on hemodialysis were evaluated before and 6 months after the kidney transplantation. They were all recipients of their first kidney allografts from living unrelated donors and had a functional kidney allograft during the follow-up. The 5-item version of the International Index of Erectile Function (IIEF-5) was used to assess their erectile function. A group of age-matched controls were compared with them before transplantation. The effects of pretransplant IIEF-5 score, age at transplantation, the artery used for anastomosis, and duration of the dialysis prior to transplantation on ED were also studied.

Fifty-six of the patients (87.5%) and 23 of the controls (35.9%) had ED (P < .001). The prevalence of ED was 87.5% in the hemodialysis patients. There was no relationship between the duration of dialysis and the severity of ED. Successful transplantation improved IIEF-5 score significantly (13.6 5.2 before and 19.2 5.0 after transplantation; P < .001). Based on the IIEF-5 scores, the severity of ED increased in 6 (9.4%) patients; 8 (12.5%) experienced no change in their erectile function; and 50 (78.1%) reported an improved erectile function. Preoperative IIEF-5 score and age at transplantation had statistically significant associations with ED improvement (P < .001; P = .02).

Erectile dysfunction is highly prevalent in hemodialysis patients and significantly improves after successful kidney transplantation. Younger patients with a less severe ED have the most improvement after transplantation.