title: Kidney-pancreas transplantation is associated with near-normal sexual function in uremic type 1 diabetic patients.
abstract: BACKGROUND
  Sexual function is altered in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD), thus affecting quality of life. The present study aimed to analyze sexual function in patients with T1D and ESRD (T1D+ESRD) who received a simultaneous kidney-pancreas (KP) or kidney-alone (KD) transplantation.
  
  
  METHODS
  Ten KP, 10 KD, 9 T1D+ESRD patients and 11 healthy control subjects were evaluated according to the following parameters: (1) medical/sexual history and physical examination; (2) International Index of Erectile Function; (3) Beck's inventory for depression; (4) assessment of hormonal profile; (5) quantitative sensory testing of both hand and penile sensory thresholds; and (6) hemodynamic penile assessment.
  
  
  RESULTS
  Controls and KP patients showed a higher rate of self-reported satisfactory erectile function as compared with KD and T1D+ESRD patients. Circulating androgens level resulted lower in both groups of transplanted patients and in patients with T1D+ESRD compared with healthy controls, albeit a relatively better profile was observed in KP. Both transplanted and T1D+ESRD patients showed peripheral hyposensitivity; however, healthy controls and KP showed better penile hemodynamic parameters compared with KD and T1D+ESRD.
  
  
  CONCLUSIONS
  Our study demonstrates that sexual function, circulating sex steroids milieu, penile sensitivity, and hemodynamics are near-normalized for the most part in KP transplantation. Further studies are needed to assess the beneficial role and the overall impact of KP transplantation on sexual function in a long-term setting and a larger cohort of patients.
authors.affiliation: Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Francesca
authors.initials: F
authors.lastname: D'Addio
authors.forename: Chiara
authors.initials: C
authors.lastname: Gremizzi
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Federico
authors.initials: F
authors.lastname: Dehò
authors.forename: Rossana
authors.initials: R
authors.lastname: Caldara
authors.forename: Elena
authors.initials: E
authors.lastname: Orsenigo
authors.forename: Carlo
authors.initials: C
authors.lastname: Staudacher
authors.forename: Carlo
authors.initials: C
authors.lastname: Socci
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Antonio
authors.initials: A
authors.lastname: Secchi
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Paolo
authors.initials: P
authors.lastname: Fiorina
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000503:physiopathology*; D007172:Erectile Dysfunction / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000502:physiology*; D010413:Penis / Q000098:blood supply / Q000503:physiopathology; D012725:Sexual Behavior / Q000502:physiology*; D014511:Uremia / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*
chemical_list: D001786:Blood Glucose