Factors influencing male sexual impotence after renal transplantation

Sexual impotence has been reported sixfold after sequential renal transplantation. The effects of race, age, diabetes mellitus, hypertension, uremia, arteriosclerosis (by ABI = ankle BP/brachial BP), penile blood flow (by PBI = penile BP/brachial BP), length of dialysis and transplantation, and patency of hypogastric arteries (by angiogram and operative description) on impotence were examined in a retrospective study of 61 male transplant patients followed from six to 108 months and a prospective study of 15 patients evaluated before and after transplantation with a six-month follow-up. Age (greater than forty years) was the only factor deleterious to male potency (potent patients 40.1 +/- 10.40 years vs impotent patients 48.6 +/- 10.06 years significant at p less than 0.006). Impotence did not correlate with ABI and PBI. Interruption of both hypogastric arteries is not necessarily related to impotence. Vascular impotence is more uncommon in renal transplant recipients than we had anticipated. Post-transplantation male impotence is perhaps best treated by penile prosthesis insertion.