Effect of the use of internal iliac artery for renal transplantation on penile vascularity and erectile function: a prospective study.
OBJECTIVE
We determined the effects of the use of internal iliac artery for renal transplantation on erectile function and penile hemodynamics in prospective fashion.


METHODS
The study comprised 50 patients with chronic renal failure on hemodialysis without associated vascular risk factors. All patients were evaluated before and after renal transplantation with 6-month followup. All grafts were revascularized with end-to-end anastomosis to the right internal iliac artery. Before and after transplantation the patients were evaluated by detailed history, including the International Index of Erectile Function, clinical examination, laboratory investigations and pharmacodynamic penile color duplex ultrasonography.


RESULTS
Erectile dysfunction was reported by 28% of the patients with chronic renal failure. This incidence becomes 26% after transplantation. Based on questionnaires post-transplantation erectile function compared to pre-transplant status was improved, deteriorated or remained static in 40%, 18% and 42% of transplant recipients, respectively. The International Index of Erectile Function showed no differences between pre-transplantation and posttransplantation sexual function except in the domain of sexual desire. In comparison to preoperative penile indices, there was a significant decrease in penile arterial blood flow in the 2 cavernous arteries (p <0.05). However, none of the patients had penile arterial insufficiency.


CONCLUSIONS
Renal transplantation has varying effects on erectile function. In the majority of cases it has no negative effect on the quality of erection. In the absence of associated vascular risk factors unilateral interruption of the internal iliac artery decreases arterial penile blood flow but not to a degree that compromise erectile function.
El-Bahnasawy
Magdy Salama
MS
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
El-Assmy
Ahmed
A
Dawood
Ahmed
A
Abobieh
Essam
E
Dein
Bedeir Ali-El
BA
El-Din
Ahmed Bayoumi Shehab
AB
El-Hamady
Salah El-Din
Sel-D
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D018783:Impotence, Vasculogenic / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000098:blood supply*; D011446:Prospective Studies; D012039:Regional Blood Flow