title: Male sexual dysfunction in patients with chronic end-stage renal insufficiency and in renal transplant recipients.
abstract: METHODS
  The study was conducted from December 2011 to December 2012 on 95 patients between the ages of 20 and 65 years: 44 of which had been undergoing dialysis for over a year and 51 of whom had undergone kidney transplants more than 6 months before. Comorbidities were carefully recorded, erectile function was evaluated the with IIEF5 questionnaire and serum levels of total testosterone / free and prolactin were tested at early morning (7 AM). To assess the relationship between erectile dysfunction (ED) and clinical laboratory tests, Student's t-test statistical (quantitative variables), chi-square (qualitative variables), the uni and multivariate analysis were used.
  
  
  RESULTS
  In patients undergoing dialysis and in recently transplanted patients a higher instance of ED was found (70% and 65% of cases respectively). Amongst dialyzed patients, patients aged over 50 suffer from ED more frequently. Patients aged over 50s represent 61% of the total number of patients suffering from ED, and just 31% of patients not suffering from ED, (p = 0.006); Hyperprolactinemia was found in 23% and 20% of both groups respectively. Fifty nine % of the dialyzed patients presented values of testosterone serum levels of less than 250 ng/dl with a significant difference between those who were suffering from ED and those who were not (65% of ED patients vs. 46%,of patients not affected from ED p = 0.019). This was found in only 37% of transplanted patients and there does not appear to be a statistically significant correlation with the onset of ED (p = 0.12). In patients over the age of 50, diabetes and a condition of hypotestosteronemia were significantly correlated with ED at univariate and multivariate analyses.
  
  
  CONCLUSIONS
  The ED in patients with end stage chronic kidney failure (CKF) continues to have a strong prevalence, either in the patients who are undergoing dialysis or in those who have received transplants. In literature this issue is not sufficiently considered if not at all. Hypotestosteronemia is a risk factor for the onset of ED in end stage CKF patients. A significantly lower prevalence of hypogonadism among dialyzed patents and transplant recipients suggests that renal transplantation may be protective for the sexual capabilities of these patients.
authors.affiliation: Department of Urology Clinic, Catholic University of S. Heart, Rome. mic.antonucci@yahoo.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Antonucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Palermo
authors.forename: Salvatore Marco
authors.initials: SM
authors.lastname: Recupero
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bientinesi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Presicce
authors.forename: Nazario
authors.initials: N
authors.lastname: Foschi
authors.forename: PierFrancesco
authors.initials: P
authors.lastname: Bassi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gulino
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000728:Androgens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D048909:Diabetes Complications / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects*; D015995:Prevalence; D011388:Prolactin / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood*
chemical_list: D000728:Androgens; D015415:Biomarkers; D013739:Testosterone; D011388:Prolactin