[Erectile dysfunction and renal chronic insufficiency: etiology and management].
Erectile dysfunction (ED) has a higher incidence in patients treated for chronic renal insufficiency or in patients who underwent kidney transplanation as it concerns more than 50% of them. Its severity is directly linked with the seriousness of the renal disease. ED is responsible of a deterioration of the quality of life. ED's physiopathology is complex and multifactorial, involving a combination of classical risk factors (endothelial dysfunction), specific factors (e.g., chronic hyperuremia and co-morbidities) and psychological factors. Management of ED must take into account both sides of the disease in order to propose appropriate treatment; i.e, psychological concerns and organic matters. Although literature remains poor in this area, phosphodiesterase-5 inhibitors are increasingly used for these patients as they are safe and efficient most of the time. Pharmacokinetics of phosphodiesterase-5 inhibitors can be disturbed by the simultaneous use of immunosuppressor. As a second line, intra-cavernous injections remain a gold-standard treatment. In case of failure, penile prosthesis can even be considered in case of renal chronic insufficiency and in transplanted patients.
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Service d'urologie, hôpital Tenon, AP-HP, faculté de médecine Pierre-et-Marie-Curie, université Paris-VI, groupe hospitalo-universitaire Est, 4, rue de la Chine, 75020 Paris, France.
Roupret
M
M
Ferhi
K
K
Barrou
B
B
Cussenot
O
O
Traxer
O
O
Haab
F
F
Beley
S
S
D007172:Erectile Dysfunction / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors; D011795:Surveys and Questionnaires
D058986:Phosphodiesterase 5 Inhibitors