Mirone V et al. (2008) Renal transplantation does not improve erectile function in hemodialysed patients. Eur Urol [doi: 10.1016/j.eururo.2008.09.020]

Erectile dysfunction (ED) is common in men with end-stage renal disease (ESRD); however, whether normalization of kidney function by renal transplantation can improve ED in such individuals is not known. Mirone et al. used the International Index of Erectile Function (IIEF) to assess ED before and 1 year after successful renal transplantation in 78 men with ESRD.

The overall prevalence of ED at baseline was 87.17%, and was higher in men aged <45 years (n = 32) than in those aged ≥45 years (n = 46; 90.62% vs 82.60%). One year after transplantation, the overall prevalence of ED had risen to 91.02%. The mean total IIEF score after transplantation was not significantly different from baseline in men aged ≥45 years, but was significantly decreased in those aged <45 years (P = 0.01). A significant decrease in mean total IIEF score was reported in patients with dyslipidemia (P = 0.008) and in those receiving methylprednisolone (P = 0.0204) or ciclosporin (P = 0.045). Those patients using β-blockers, Ca2+ antagonists or angiotensin-converting-enzyme inhibitors had a significant decrease in the mean IIEF erectile function domain score compared with baseline values (P = 0.0355, P = 0.0204 and P = 0.045, respectively).

ED is prevalent in men with ESRD, and is not affected by renal transplantation in men aged 45 years or over; however, transplantation is associated with deterioration in erectile function in men younger than 45 years. The authors recommend psychological counseling and careful moderation of medication for men with ESRD and ED undergoing renal transplantation.