Erectile dysfunction in kidney transplanted patients: efficacy of sildenafil.
BACKGROUND
Erectile dysfunction (ED) is the inability to achieve and/or maintain an erection for satisfactory sexual performance. The effects of kidney transplantation on pre-existing ED are poorly understood, as well as the onset of new ED cases after kidney transplantation. This study aimed to evaluate the effects of kidney transplantation on pre-existing ED, to assess the onset of new ED cases after renal transplantation and to assess both the efficacy and safety of sildenafil.


METHODS
Erectile function was assessed using the self-administered International Index of Erectile Function (IIEF) to kidney transplanted patients. A 50 mg dose of sildenafil was prescribed. Sildenafil efficacy was assessed by re-administering the questionnaire after 4 weeks of therapy. Blood chemistry and serum cyclosporine concentration were evaluated at the beginning of the study and, in patients treated with sildenafil, after 4 weeks of treatment.


RESULTS
One hundred and thirteen patients (87.5%) completed the questionnaire. Fifty-three patients (47%) did not complain of ED, the remaining 60 patients (53%) reported ED. ED was already present during dialysis in 40 patients; it appeared ex novo in 20 patients after transplantation. Pre-existing ED disappeared in 8 patients (20%), ameliorated in 13 patients (32.5%), worsened in 2 patients (5%), and remained unchanged in 17 patients (42.5%) after transplantation. The IIEF score significantly improved in sildenafil-treated patients (n=20); there were no observed changes in blood chemistry, blood pressure (BP), renal function and cyclosporine concentration. The side-effects were minimal.


CONCLUSIONS
ED was still present in a large cohort of kidney transplanted men. Renal transplantation cures few ED cases. ED can appear ex novo after transplantation. Sildenafil is an effective ED treatment in kidney transplanted men.
Departments of Nephrology, School of Medicine, University Federico II Naples, Naples, Italy. gigi.russo@libero.it
Domenico
D
Russo
Dario
D
Musone
Vincenzo
V
Alteri
Luca
L
Cindolo
Bernardo
B
Lanzillo
Stefano
S
Federico
Vittorio E
VE
Andreucci
D000328:Adult; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate