Abstract
Our goal is to evaluate the association between histopathology of glomerulosclerosis (GS) and atherosclerosis (AS) in the nephrectomized normal parenchyma together with patients’ background, and erectile dysfunction (ED) of patients treated with radical nephrectomy (RN) for renal cell carcinoma (RCC). ED was assessed with the International Index of Erectile Function in 65 patients who were less than age 70 years at the time of questionnaire. Glomeruli status was assessed by the extent of global GS. AS was graded based on lumen occlusion and frequency of involvement. Patients’ backgrounds included any comorbidities, post-RN renal insufficiency, tumor pathology, demographics and social status. The presence of diabetes mellitus and lack of a spouse were independent predictors for severe ED, whereas G0/1 AS was an independent predictor for mild/no ED. The extent of global GS was significantly lower in patients with mild/no ED than in other patients. Our study represents the first report identifying healthy arterial status in the renal parenchyma as a significant indicator of favorable erectile function and that the evaluation of AS severity is not a superior indicator of severe ED in the presence of comorbidities or social status among patients treated with RN.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Costa C, Virag R . The endothelial-erectile dysfunction connection: an essential update. J Sex Med 2009; 6: 2390–2404.
Guay AT . ED2: erectile dysfunction=endothelial dysfunction. Endocrinol Metab Clin North Am 2007; 36: 453–463.
Bellinghieri G, Savica V, Santoro D . Vascular erectile dysfunction in chronic renal failure. Semin Nephrol 2006; 26: 42–45.
Navaneethan SD, Vecchio M, Johnson DW, Saglimbene V, Graziano G, Pellegrini F et al. Prevalence and correlates of self-reported sexual dysfunction in CKD: a meta-analysis of observational studies. Am J Kidney Dis 2010; 56: 670–685.
Mehrsai A, Mousavi S, Nikoobakht M, Khanlarpoor T, Shekarpour L, Pourmand G . Improvement of erectile dysfunction after kidney transplantation: the role of the associated factors. Urol J 2006; 3: 240–244.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY . Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2008; 351: 1296–1305.
Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003; 44: 360–354.
Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294: 2996–3002.
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009; 53: 982–992.
Bijol V, Mendez GP, Hurwitz S, Rennke HG, Nosé V . Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure. Am J Surg Pathol 2006; 30: 575–584.
de Araujo AC, da Silva FG, Salvi F, Awad MC, da Silva EA, Damião R . The management of erectile dysfunction with placebo only: does it work? J Sex Med 2009; 6: 3440–3448.
Wang Y, Bao X . Effects of uric acid on endothelial dysfunction in early chronic kidney disease and its mechanisms. Eur J Med Res 2013; 18: 26.
Choi JH, Kim KL, Huh W, Kim B, Byun J, Suh W et al. Decreased number and impaired angiogenic function of endothelial progenitor cells in patients with chronic renal failure. Arterioscler Thromb Vasc Biol 2004; 24: 1246–1252.
Leavey SF, Weitzel WF . Endocrine abnormalities in chronic renal failure. Endocrinol Metab Clin North Am 2002; 31: 107–119.
Abdel-Gawad M, Huynh H, Brock GB . Experimental chronic renal failure-associated erectile dysfunction: molecular alterations in nitric oxide synthase pathway and IGF-I system. Mol Urol 1999; 3: 117–125.
Lane BR, Campbell SC, Demirjian S, Fergany AF . Surgically induced chronic kidney disease may be associated with a lower risk of progression and mortality than medical chronic kidney disease. J Urol 2013; 189: 1649–1655.
Kopp RP, Dicks BM, Goldstein I, Mehrazin R, Silberstein JL, Colangelo CJ et al. Does radical nephrectomy increase the risk of erectile dysfunction compared with partial nephrectomy? A cohort analysis. BJU Int 2013; 111: E98–102.
Guo P, Xie Z, Wang Y, Wang J . Prevalence of erectile dysfunction in living donors before and after nephrectomy in China. Urology 2010; 76: 370–372.
Bonsib SM, Pei Y . The non-neoplastic kidney in tumor nephrectomy specimens: what can it show and what is important? Adv Anat Pathol 2010; 17: 235–250.
Gautam G, Lifshitz D, Shikanov S, Moore JM, Eggener SE, Shalhav AL et al. Histopathological predictors of renal function decrease after laparoscopic radical nephrectomy. J Urol 2010; 184: 1872–1876.
Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003; 44: 360–364.
Ponholzer A, Stopfer J, Bayer G, Susani M, Steinbacher F, Herbst F et al. Is penile atherosclerosis the link between erectile dysfunction and cardiovascular risk? An autopsy study. Int J Impot Res 2012; 24: 137–140.
Keddis MT, Garovic VD, Bailey KR, Wood CM, Raissian Y, Grande JP . Ischaemic nephropathy secondary to atherosclerotic renal artery stenosis: clinical and histopathological correlates. Nephrol Dial Transplant 2010; 25: 3615–3622.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Sejima, T., Iwamoto, H., Masago, T. et al. Initial evidence demonstrating the association between the vascular status in surgically resected renal parenchymal pathology and sexual function. Int J Impot Res 27, 90–94 (2015). https://doi.org/10.1038/ijir.2014.38
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ijir.2014.38