|
1
|
Fu R, He P, Hong W, Liang Y, Wang W, Yuan S, Liu L. Male sexual dysfunction in patients with chronic kidney disease: a cross-sectional study. Sci Rep 2024; 14:9207. [PMID: 38649741 PMCID: PMC11035701 DOI: 10.1038/s41598-024-59844-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
Sexual dysfunction is common in males with chronic kidney disease (CKD), but yet the prevalence and specific relationship between CKD and sexual dysfunction, especially premature ejaculation (PE), remain to be investigated in China; This study aims to examine the prevalence and association between CKD and sexual dysfunction in male patients in China; In this cross-sectional, non-interventional, observational study conducted at a single center. 72 male patients with CKD were enrolled. Data collection included socio-demographic information, assessments via the 5-item version of the International Index of Erectile Function (IIEF-5), the Chinese version of the Premature Ejaculation Diagnostic Tool, the Patient Health Quentionnnaire-9 and the General Anxiety Disorder-7. Data analysis was performed using R version 3.5.2 and SPSS software version 25.0; Among the 72 CKD patients, 56.9% experienced erectile dysfunction and 29.2% had PE. Various factors including estimated Glomerular Filtration Rate, Albumin-to-Creatinine Ratio, psychological aspects, medication use were found to be associated with sexual dysfunction in these CKD patients; Sexual dysfunction is prevalent in males with CKD and is, influenced by multiple factors. It is important for clinicians to focus on sexual dysfunction in this patient group and further investigate its underlying mechanisms.
Collapse
Affiliation(s)
- Ruijie Fu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Peihua He
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Weihong Hong
- Department of Nephrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, 519015, China
| | - Yichun Liang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Wen Wang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Shaoying Yuan
- Department of Andrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, 519015, China.
| | - Lichang Liu
- Department of Nephrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, 519015, China.
| |
Collapse
|
|
2
|
Mondal S, Sinha Roy PP, Pal DK. Sexual well-being and fertility in male renal transplant recipients: A study in a tertiary care centre. Urologia 2022; 89:636-640. [PMID: 35894502 DOI: 10.1177/03915603221114612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Sexual dysfunction is a common problem among chronic kidney disease (CKD) patients. The uraemia, comorbid conditions, hormonal disturbances, autonomic neuropathy, side effects of medication and psycho-social factors contribute to sexual dysfunction. These factors also affect fertility of CKD patients. It starts early in CKD and gradually deteriorates with time. Renal transplant corrects most of the issues and leads to improvement of sexual function which ultimately leads to improved fertility outcomes. METHODS It was a cross sectional study performed in a single institution including 135 male renal transplant recipients. A questionnaire was used to evaluate the socio-economic status, fertility and developmental condition of the off-springs. The International index of erectile dysfunction (IIEF) was used for assessment of sexual well-being of the patient. The data were statistically analysed by SPSS 25.0 version. RESULTS The mean age at transplant was 40.9 ± 9.9 years and the duration of haemodialysis received 13.6 ± 7.43 months. Among 135 recipients 63 (46.67%) desired but only 49 were successful to father a child. Upper middle class being the largest group to receive renal transplant also had the highest fertility rate in our study. The children born had no development anomaly. Sexual function improved in 85 patients, worsened in 15 and remain unchanged among 35 patients after renal transplant. Overall there was significant improvement in all five parameters of IIEF. CONCLUSION Renal transplant corrects most of the metabolic abnormality as well gives a psychological boost to the CKD patients. These lead to improvement of sexual functions which in turn improves the fertility in renal transplant recipients. But the overall fertility rate among the male renal transplant recipients was comparable to the general population.
Collapse
Affiliation(s)
- Soumya Mondal
- Department of Urology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | | | - Dilip Kumar Pal
- Department of Urology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| |
Collapse
|
|
3
|
Luo L, Xiao C, Xiang Q, Zhu Z, Liu Y, Wang J, Deng Y, Zhao Z. Significant Increase of Sexual Dysfunction in Patients With Renal Failure Receiving Renal Replacement Therapy: A Systematic Review and Meta-Analysis. J Sex Med 2020; 17:2382-2393. [PMID: 33082104 DOI: 10.1016/j.jsxm.2020.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND It has been shown that sexual dysfunction (SD) is highly prevalent among patients with chronic renal failure (CRF), and starting renal replacement therapy may even increase it. However, SD is an infrequently reported problem in these treated patients. AIM To investigate the prevalence of SD among patients with CRF undergoing renal replacement therapy, by a meta-analysis method. METHODS PubMed, Embase, and the Cochrane Library were systematically searched for all studies assessing sexual function in patients with CRF receiving renal replacement therapy from January 2000 to April 2020. Relative risk (RR) with 95% CIs was used for analysis to assess the risk of SD in patients with CRF receiving renal replacement therapy. The cross-sectional study quality methodology checklist was used for the cross-sectional study. The methodologic quality of the case-control and cohort studies was assessed with the Newcastle-Ottawa Scale. Data were pooled for the random-effect model. Sensitivity analyses were conducted to assess potential bias. The Begg and Egger tests were used for publication bias analysis. OUTCOMES The prevalence of SD among patients with CRF receiving renal replacement therapy was summarized using pooled RR and 95% CI. RESULTS This meta-analysis included 3,725 participants from 10 studies. Of these, 737 were patients with CRF receiving renal replacement therapy. The mean age of participants ranged from 32.75 to 56.1 years. Based on the random-effect model, synthesis of results demonstrated that the prevalence of SD was significantly increased among patients with CRF receiving renal replacement therapy in women (RR = 2.07, 95% CI: 1.47-2.91, P = .000; heterogeneity: I2 = 78.7%, P = .000) and in men (RR = 2.95, 95% CI: 2.16-4.02, P = .000; heterogeneity: I2 = 86.1%, P = .000). Estimates of the total effects were generally consistent in the sensitivity analysis. No evidence of publication bias was observed. CLINICAL IMPLICATIONS Patients with CRF receiving renal replacement therapy had a significantly increased risk of SD, which suggests that clinicians should evaluate sexual function, when managing patients with CRF receiving renal replacement therapy. STRENGTHS AND LIMITATIONS This is the first study to explore the prevalence of SD among patients with CRF undergoing renal replacement therapy based on all available epidemiologic studies. However, all included studies were an observational design, which may downgrade this evidence. CONCLUSION The prevalence of SD is significantly increased among patients with CRF receiving renal replacement therapy. More research studies are warranted to clarify the relationship. Luo L, Xiao C, Xiang Q, et al. Significant Increase of Sexual Dysfunction in Patients With Renal Failure Receiving Renal Replacement Therapy: A Systematic Review and Meta-Analysis. J Sex Med 2020;17:2382-2393.
Collapse
Affiliation(s)
- Lianmin Luo
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Chenglin Xiao
- Department of Urology, The Second Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Qian Xiang
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Zhiguo Zhu
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Yangzhou Liu
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Jiamin Wang
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Yihan Deng
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Zhigang Zhao
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China.
| |
Collapse
|
|
4
|
Pizzol D, Xiao T, Yang L, Demurtas J, McDermott D, Garolla A, Nardelotto A, Grabovac I, Soysal P, Kazancioglu RT, Veronese N, Smith L. Prevalence of erectile dysfunction in patients with chronic kidney disease: a systematic review and meta-analysis. Int J Impot Res 2020; 33:508-515. [PMID: 32358511 DOI: 10.1038/s41443-020-0295-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 01/03/2023]
Abstract
Growing evidence reports that chronic kidney diseases (CKD) might play a role in erectile dysfunction (ED), but limited knowledge is available. Therefore, we performed a systematic review up to 21/08/2019 to investigate the associations between CKD and ED. The main analysis reported the prevalence of ED as absolute estimates (in %) with their 95% confidence intervals (CIs) and across CKD stages (when specified), hemodialysis and transplant, calculating the p for interaction across strata. Among 291 studies, we included 34 articles with 5986 men. We found an overall prevalence of 76% (95%CI: 72-79) with a high degree of heterogeneity (I2 = 84.2%; p < 0.0001). Analyzing the data by CKD stage, we found a significant higher prevalence of ED in CKD (78%; 95%CI: 75-81%; I2 = not possible) compared with hemodialysis stage (prevalence = 77%; 95%CI: 73-80%; I2 = 84.5) or to patients undergoing transplant (prevalence = 64%; 95%CI: 54-74%; I2 = 54%) (p across strata = 0.036). Considering the high prevalence of ED in men with CKD, health care practitioners should focus on issues of sexual health in men with CKD. Given the advancements in dialysis and therapy and the associated advancements in survival and life expectancy, maintaining the patients' sexual function is important for their well-being and quality of life.
Collapse
Affiliation(s)
- Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan.
| | - Tao Xiao
- College of Mathematics and Statistics, Shenzhen University, Shenzhen, 518060, China
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, T2S 3C3, Canada.,Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Jacopo Demurtas
- Primary Care Department Azienda USL Toscana Sud Est, Grosseto, Italy
| | - Daragh McDermott
- School of Psychology and Sport Science, Anglia Ruksin University, Cambridge, UK
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Antonella Nardelotto
- Unit of Nephrology and Dialysis, AULSS (Azienda Unità Locale Socio Sanitaria) 3 "Serenissima", 30031, Dolo, Mirano, Italy
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
|
5
|
Oueslati I, Ounissi M, Azaiez S, Talbi E, Belagha J, Khiari K. Prévalence et facteurs de risque de la dysfonction érectile chez les insuffisants rénaux chroniques. AFRICAN JOURNAL OF UROLOGY 2017. [DOI: 10.1016/j.afju.2017.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
|
6
|
Prevalence and factors associated with erectile dysfunction in patients with chronic kidney disease on conservative treatment. Int J Impot Res 2017; 29:219-224. [DOI: 10.1038/ijir.2017.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 02/05/2017] [Accepted: 03/02/2017] [Indexed: 12/19/2022]
|
|
7
|
Kharbach Y, Bourouhou H, Tenkorang S, Mellas S, EL Ammari JE, Tazi M, Khallouk A, EL Fassi M, Sqalli Houssaini T, Farih M. Corrélations entre la dysfonction sexuelle et le profil clinicobiologique de l’insuffisant rénal en hémodialyse. AFRICAN JOURNAL OF UROLOGY 2016. [DOI: 10.1016/j.afju.2016.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
|
8
|
Sumii K, Miyake H, Yoshiya K, Enatsu N, Matsushita K, Hara S, Fujisawa M. Erectile function and its impact on quality of life in Japanese men on hemodialysis. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1211594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Kenta Sumii
- Faculty of Medicine, Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kunihiko Yoshiya
- Department of Nephrology, Hara Genitourinary Hospital, Kobe, Japan
| | - Noritoshi Enatsu
- Faculty of Medicine, Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Kei Matsushita
- Faculty of Medicine, Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Shoji Hara
- Department of Urology, Hara Genitourinary Hospital, Kobe, Japan
| | - Masato Fujisawa
- Faculty of Medicine, Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| |
Collapse
|
|
9
|
Papadopoulou E, Varouktsi A, Lazaridis A, Boutari C, Doumas M. Erectile dysfunction in chronic kidney disease: From pathophysiology to management. World J Nephrol 2015; 4:379-387. [PMID: 26167462 PMCID: PMC4491929 DOI: 10.5527/wjn.v4.i3.379] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 12/27/2014] [Accepted: 05/28/2015] [Indexed: 02/06/2023] Open
Abstract
Chronic kidney disease (CKD) is encountered in millions of people worldwide, with continuously rising incidence during the past decades, affecting their quality of life despite the increase of life expectancy in these patients. Disturbance of sexual function is common among men with CKD, as both conditions share common pathophysiological causes, such as vascular or hormonal abnormalities and are both affected by similar coexisting comorbid conditions such as cardiovascular disease, hypertension and diabetes mellitus. The estimated prevalence of erectile dysfunction reaches 70% in end stage renal disease patients. Nevertheless, sexual dysfunction remains under-recognized and under-treated in a high proportion of these patients, a fact which should raise awareness among clinicians. A multifactorial approach in management and treatment is undoubtedly required in order to improve patients’ quality of life and cardiovascular outcomes.
Collapse
|
|
10
|
Costa MR, Reis AMBB, Pereira BP, Ponciano VC, Oliveira ECD. Associated factors and prevalence of erectile dysfunction in hemodialysis patients. Int Braz J Urol 2014; 40:44-55. [PMID: 24642163 DOI: 10.1590/s1677-5538.ibju.2014.01.07] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 11/14/2013] [Indexed: 02/11/2023] Open
Abstract
PURPOSE The proposal of this study was to determine the prevalence and the associated factors of erectile dysfunction (ED) among hemodialysis (HD) patients. MATERIALS AND METHODS This was a cross-sectional study based on data collected from HD male patients. Clinical, demographic and laboratory data of all patients were collected in three HD clinics from December 2010 to June 2011. Patients answered questions of erectile function domain from International Index of Erectile Function. Data were evaluated by descriptive analysis and by univariate (ULRA) and multivariate logistic regression analysis (MLRA). RESULTS Three hundred and five patients participated of the study. The prevalence of ED was 68.19%. ED was associated with diabetes (DM), benign prostatic hyperplasia, glomerulonephritis as cause of chronic renal failure (CRF), smoking habits, lower creatinine levels (ULRA), use of calcium channel blocker (MLRA), aging, lower education level, alcohol consumption, DM (as cause of CRF) and coronary insufficiency (ULRA and MLRA). CONCLUSIONS ED was highly prevalent in the HD men. It was independently associated with aging, current use of alcohol, long alcohol use (even for those who do not drink more), lower education level, diabetes as cause of CRF, coronary insufficiency and use of channel blockers calcium.
Collapse
Affiliation(s)
- Márcio Rodrigues Costa
- Division of Urology, Department of Surgery, Hospital das Clinicas, Federal University of Goiás Medical School, Goiânia, Brazil
| | | | - Bruno Paiva Pereira
- Division of Urology, Department of Surgery, Hospital das Clinicas, Federal University of Goiás Medical School, Goiânia, Brazil
| | - Viviane Campos Ponciano
- Division of Urology, Department of Surgery, Hospital das Clinicas, Federal University of Goiás Medical School, Goiânia, Brazil
| | - Enio Chaves de Oliveira
- Division of Urology, Department of Surgery, Hospital das Clinicas, Federal University of Goiás Medical School, Goiânia, Brazil
| |
Collapse
|
|
11
|
Dikici S, Bahadir A, Baltaci D, Ankarali H, Eroglu M, Ercan N, Sav T. Association of anxiety, sleepiness, and sexual dysfunction with restless legs syndrome in hemodialysis patients. Hemodial Int 2014; 18:809-18. [DOI: 10.1111/hdi.12175] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Suber Dikici
- Medical Faculty; Neurology Department; Duzce University; Duzce Turkey
| | - Anzel Bahadir
- Medical Faculty; Biophysics Department; Duzce University; Duzce Turkey
| | - Davut Baltaci
- Medical Faculty; Family Medicine Department; Duzce University; Duzce Turkey
| | - Handan Ankarali
- Medical Faculty; Biostatistics Department; Duzce University; Duzce Turkey
| | | | - Nurten Ercan
- Medical Faculty; Neurology Department; Duzce University; Duzce Turkey
| | - Tansu Sav
- Medical Faculty; Hemodialysis Department; Duzce University; Duzce Turkey
| |
Collapse
|
|
12
|
Theofilou P, Synodinou C, Panagiotaki H. Undergoing Haemodialysis: A Qualitative Study to Investigate the Lived Experiences of Patients. EUROPES JOURNAL OF PSYCHOLOGY 2013. [DOI: 10.5964/ejop.v9i1.338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
|
13
|
Santos PR, Capote JRFG, Cavalcanti JU, Vieira CB, Rocha ARM, Apolônio NAM, de Oliveira EB. Quality of life among women with sexual dysfunction undergoing hemodialysis: a cross-sectional observational study. Health Qual Life Outcomes 2012; 10:103. [PMID: 22937965 PMCID: PMC3492173 DOI: 10.1186/1477-7525-10-103] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Accepted: 07/06/2012] [Indexed: 11/17/2022] Open
Abstract
Background Sexual function among women undergoing hemodialysis (HD) is under-studied and there is no consensus about the effect of sexual dysfunction (SD) on their quality of life (QoL). We aimed to determine the prevalence of SD and to compare QoL between women undergoing maintenance HD with and without SD. Methods We included female end-stage renal disease (ESRD) patients undergoing HD during June 2011 in the only renal unit in the north of Ceará state, northeastern Brazil. The criteria for inclusion were age between 18 and 55, at least three months on dialysis and being sexually active. Women using antidepressant medication were excluded. We used the Female Sexual Function Index (FSFI), which evaluates six domains of sexual function, including desire, arousal, lubrication, orgasm, satisfaction and pain. The patients were classified as presenting SD if the total FSFI score was less than 26. For QoL evaluation, we used the validated Brazilian version of SF-36. This is a widely used 36-item questionnaire covering eight dimensions of QoL. Demographic data, time on dialysis, underlying etiology of ESRD, and laboratory measures were assessed in unit records. Results Of a total of 58 women, 46 (79.3%) presented SD. There were lower scores related to physical functioning (48.2 vs. 71.2; p = 0.007), bodily pain (45 vs. 67.5; p = 0.010), vitality (52.1 vs. 69.1; p = 0.026) and social functioning (57.2 vs. 76.1; p = 0.034) among women with SD compared to women without SD. Physical functioning and role-physical presented positive linear correlation with FSFI scores, respectively, r = 0.322 (p = 0.013) and r = 0.345 (p = 0.007). Conclusion The prevalence of SD among women on HD is very high, reaching nearly 80%. Women on HD with SD had worse QoL, especially physical aspects of QoL, when compared to women without SD. Therefore, approaches aiming to improve QoL among women undergoing HD should be considered.
Collapse
Affiliation(s)
- Paulo Roberto Santos
- Sobral School of Medicine, Federal University of Ceará, Avenida Comandante Meurocélio Rocha Ponte 100, CEP: 62.042-2800 Sobral, CE, Brazil.
| | | | | | | | | | | | | |
Collapse
|
|
14
|
Shiraishi K, Shimabukuro T, Matsuyama H. The prevalence of Peyronie's disease in Japan: a study in men undergoing maintenance hemodialysis and routine health checks. J Sex Med 2012; 9:2716-23. [PMID: 22897619 DOI: 10.1111/j.1743-6109.2012.02868.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The incidence of Peyronie's disease (PD) in the general population is believed to be as high as 20%. However, most of the data concerning the prevalence of PD have been obtained from Caucasian populations. AIM The aim of this study was to examine the prevalence of PD in Asia and among men undergoing hemodialysis and discuss the pathophysiology of PD. METHODS A total of 1,090 men who received a routine health check at our hospital (control group) as well as 130 male patients undergoing maintenance hemodialysis were enrolled. The diagnosis of PD was based on a palpable penile plaque. MAIN OUTCOME MEASURES Hemodialysis patients were asked about their sexual activity and completed the International Index of Erectile Function-5 questionnaires. The differences between patients' and hemodialysis-associated factors, comorbidities, and medications were statistically assessed for patients with and without PD. RESULTS The prevalence of PD was significantly increased among hemodialysis patients (12 patients: 9.2%) relative the control group (six men: 0.6%) (P<0.0001, odds ratio: 18.4). In both groups, the plaques were primarily allocated dorsally. In the hemodialysis patients with PD, the frequency of masturbation (P<0.05) and the incidence of moderate or severe erectile dysfunction (P<0.01) were significantly higher than those among hemodialysis patients without PD. In comparison with patients without PD, the number of acetate dialysate users was significantly higher among patients with PD (P<0.05), and none of the PD patients used angiotensin-related antihypertensive drugs (P<0.05). CONCLUSIONS The prevalence of PD in healthy Japanese men is low (0.6%), which suggests the existence of racial differences in the prevalence of PD. Moreover, these results indicate that hemodialysis increases the incidence of PD. The differences in the characteristics between male hemodialysis patients with and without PD provide new insights into the pathophysiology and therapeutic window of PD.
Collapse
Affiliation(s)
- Koji Shiraishi
- Department of Urology, Yamaguchi University School of Medicine, Department of Urology, UBE Industries Central Hospital, Ube, Yamaguchi, Japan.
| | | | | |
Collapse
|
|
15
|
Theofilou PA. Sexual functioning in chronic kidney disease: the association with depression and anxiety. Hemodial Int 2012; 16:76-81. [PMID: 22099520 DOI: 10.1111/j.1542-4758.2011.00585.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Sexual functioning is composed of both physiological and psychological factors among patients with chronic kidney disease (CKD). However, the role of depression and anxiety has not yet been studied extensively. This study aimed to investigate the relation of depressive and anxiety symptoms to sexual functioning among hemodialysis (HD) and peritoneal dialysis patients. A sample of 144 patients was recruited from three general hospitals in the broader area of Athens, consisting of 84 patients undergoing in-center HD and 60 patients in continuous ambulatory peritoneal dialysis. Measurements were conducted with the following instruments: the World Health Organization Quality of Life instrument, the General Health Questionnaire (GHQ-28), the State-Trait Anxiety Inventory (STAI 1/STAI 2), and the Center for Epidemiologic Studies Depression Scale. The results indicated that satisfaction about sexual life had negative association with all the subscales of GHQ-28 questionnaire (somatic symptoms, anxiety/insomnia, social dysfunction, severe depression). Sexual functioning was also related negatively to depression as well as state and trait anxieties. Findings provide evidence that the presence of depressive and anxiety symptoms relates significantly to the negative evaluation of sexual functioning in patients with CKD.
Collapse
|
|
16
|
Determining the Correlation Between Sexual Satisfaction and Loneliness Levels in Patients with Hemodialysis in a Muslim Community. SEXUALITY AND DISABILITY 2011. [DOI: 10.1007/s11195-011-9252-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
|
17
|
Vecchio M, Navaneethan SD, Johnson DW, Lucisano G, Graziano G, Saglimbene V, Ruospo M, Querques M, Jannini EA, Strippoli GF. Interventions for treating sexual dysfunction in patients with chronic kidney disease. Cochrane Database Syst Rev 2010:CD007747. [PMID: 21154382 DOI: 10.1002/14651858.cd007747.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Sexual dysfunction is very common in patients with chronic kidney disease (CKD), but it is still significantly understudied. Treatment options exist but concerns have been raised relating to their efficacy and safety in CKD. OBJECTIVES We assessed the benefits and harms of existing interventions for treatment of sexual dysfunction in patients with CKD. SEARCH STRATEGY In October 2010 we searched the Cochrane Renal Group's specialised register, CENTRAL (The Cochrane Library, issue 10), MEDLINE (from 1966) and EMBASE (from 1980). SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs of any pharmacological and non-pharmacological interventions used to treat sexual dysfunction in male and female CKD patients (predialysis, dialysis and kidney transplant) were included. DATA COLLECTION AND ANALYSIS Two authors independently selected eligible studies, extracted data and assessed study quality. Disagreements were resolved in consultation with an arbitrator. Treatment effects were summarised as risk ratios (RR), mean differences (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI) using a random-effects model. MAIN RESULTS Fifteen studies (8 parallel, 7 crossover; 352 patients) were included. Only one study enrolled women. Studies evaluated the effects of phosphodiesterase-5 inhibitors (PDE5i), zinc, vitamin E, vitamin D or bromocriptine compared to placebo. PDE5i significantly increased the overall International Index of Erectile Function-5 (IIEF-5) score (2 studies, 101 patients, MD 10.65, 95% CI 5.34 to 15.96), all its individual domains and the complete 15-item IIEF tool (1 study, 41 patients, MD 2.64, 95% CI 1.32 to 3.96). End of treatment testosterone levels were not significantly increased by addition of zinc to dialysate (2 studies, 22 patients, MD 0.21 ng/mL, 95% CI -2.14 to 2.55) but oral zinc improved end of treatment testosterone levels (1 study, 20 patients, SMD 1.62, 95% CI 0.58 to 2.66). There was no difference in plasma luteinizing and follicle-stimulating hormone levels at the end of the study period with zinc therapy. Only sparse data were available for vitamin E, bromocriptine and dihydroxycholecalciferol in CKD patients and there were no studies of intracavernous injections, transurethral injections, mechanical devices or psychosexual therapies in people with CKD. AUTHORS' CONCLUSIONS PDE5i and zinc are promising interventions for treating sexual dysfunction in men with CKD. Evidence supporting their routine use in CKD patients is limited. There is an unmet need for studying interventions for both male and female sexual dysfunction in CKD, considering the significant disease burden.
Collapse
Affiliation(s)
- Mariacristina Vecchio
- Clinical Pharmacology and Epidemiology, Mario Negri Sud Consortium, Via Nazionale 8/A, Santa Maria Imbaro, Chieti, Italy, 66030
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
18
|
Navaneethan SD, Vecchio M, Johnson DW, Saglimbene V, Graziano G, Pellegrini F, Lucisano G, Craig JC, Ruospo M, Gentile G, Manfreda VM, Querques M, Stroumza P, Torok M, Celia E, Gelfman R, Ferrari JN, Bednarek-Skublewska A, Dulawa J, Bonifati C, Hegbrant J, Wollheim C, Jannini EA, Strippoli GFM. Prevalence and correlates of self-reported sexual dysfunction in CKD: a meta-analysis of observational studies. Am J Kidney Dis 2010; 56:670-85. [PMID: 20801572 DOI: 10.1053/j.ajkd.2010.06.016] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 06/22/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Sexual dysfunction is an under-recognized problem in men and women with chronic kidney disease (CKD). The prevalence, correlates, and predictors of this condition in patients with CKD have not been evaluated comprehensively. STUDY DESIGN Systematic review and meta-analysis. SETTING & POPULATION Patients treated using dialysis (dialysis patients), patients treated using transplant (transplant recipients), and patients with CKD not treated using dialysis or transplant (nondialysis nontransplant patients with CKD). SELECTION CRITERIA FOR STUDIES Observational studies conducted in patients with CKD only or including a control group without CKD. PREDICTOR Type of study population. OUTCOMES Sexual dysfunction in men and women with CKD using validated tools, such as the International Index of Erectile Function, the Female Sexual Function Index (FSFI), or other measures as reported by study investigators. RESULTS 50 studies (8,343 patients) of variable size (range, 16-1,023 patients) were included in this review. Almost all studies explored sexual dysfunction in men and specifically erectile dysfunction. The summary estimate of erectile dysfunction in men with CKD was 70% (95% CI, 62%-77%; 21 studies, 4,389 patients). Differences in reported prevalence rates of erectile dysfunction between different studies were attributable primarily to age, study populations, and type of study tool used to assess the presence of erectile dysfunction. In women, the reported prevalence of sexual dysfunction was assessed in only 306 patients from 2 studies and ranged from 30%-80%. Compared with the general population, women with CKD had a significantly lower overall FSFI score (8 studies or subgroups, 407 patients; mean difference, -9.28; 95% CI, -12.92 to -5.64). Increasing age, diabetes mellitus, and depression consistently were found to correlate with sexual dysfunction in 20 individual studies of patients with CKD using different methods. LIMITATIONS Suboptimal and lack of uniform assessment of outcome measures. CONCLUSIONS Sexual dysfunction is highly prevalent in both men and women with CKD, especially among those on dialysis. Larger studies enrolling different ethnic groups, using validated study tools, and analyzing the influence of various factors on the development of sexual dysfunction are needed.
Collapse
Affiliation(s)
- Sankar D Navaneethan
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
19
|
Erectile dysfunction among hemodialysis patients. Int Urol Nephrol 2010; 43:117-23. [PMID: 20535636 DOI: 10.1007/s11255-010-9780-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2009] [Accepted: 05/20/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Erectile dysfunction (ED) is a distressing problem in hemodialysis patients. A combination of organic and psychological factors has been reported to take part in the pathophysiology of this condition. The aim of this study is to determine the prevalence of sexual dysfunction among hemodialysis patients. METHODS From November 2008 to January 2009, a total of 59 male patients who underwent hemodialysis therapy in Jahrom and Fasa medical centers in Iran were entered the study. We explained to them each of the questions of the questionnaire and asked them to complete the IIEF questionnaire. We used the IIEF to determine the sexual problems and the prevalence of erectile dysfunction in male hemodialysis patients. We used translated (Persian) version of the IIEF questionnaire, which had been modified according to validation tests. Chi square test (Monte Carlo test) was used for analyzing the data. P value less than 0.05 was considered significant. RESULT The mean age of hemodialysis patients was 54.73 ± 14.08 years (23-78), and the duration of hemodialysis was 16.03 ± 15.66 months. By means of the IIEF, the prevalence of erectile dysfunction(ED) of any degree was 86.6%. The prevalence and the severity of ED showed significant increase as the age increased (P < 0.05). CONCLUSION Erectile dysfunction is highly prevalent in hemodialysis patients. The prevalence and the severity of ED increase with age. Evaluations and efficient therapy for ED should be included in routine assessment of hemodialysis patients.
Collapse
|
|
20
|
Vecchio M, Navaneethan SD, Johnson DW, Lucisano G, Graziano G, Querques M, Saglimbene V, Ruospo M, Bonifati C, Jannini EA, Strippoli GFM. Treatment options for sexual dysfunction in patients with chronic kidney disease: a systematic review of randomized controlled trials. Clin J Am Soc Nephrol 2010; 5:985-95. [PMID: 20498250 DOI: 10.2215/cjn.09081209] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Sexual dysfunction is very common in patients with chronic kidney disease (CKD), but treatment options are limited. The benefits and harms of existing interventions for treatment of sexual dysfunction were assessed in patients with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS MEDLINE (1966 to December 2008), EMBASE (1980 to December 2008), and the Cochrane Trial Registry (Issue 4 2008) were searched for parallel and crossover randomized and quasi-randomized trials. Treatment effects were summarized as mean differences (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) using a random effects model. RESULTS Fourteen trials (328 patients) were included. Phosphodiesterase-5 inhibitors (PDE5i) compared with placebo significantly increased the overall International Index of Erectile Function-5 (IIEF-5) score (three trials, 101 patients, MD 1.81, 95% CI 1.51 to 2.10), all of its individual domains, and the complete 15-item IIEF-5 (two trials, 80 patients, MD 10.64, 95% CI 5.32 to 15.96). End-of-treatment testosterone levels were not significantly increased by addition of zinc to dialysate (two trials, 22 patients, SMD 0.19 ng/dl, 95% CI -2.12 to 2.50), but oral zinc improved end-of-treatment testosterone levels. There was no difference in plasma luteinizing and follicle-stimulating hormone level at the end of the study period with zinc therapy. CONCLUSIONS PDE5i and zinc are promising interventions for treating sexual dysfunction in CKD. Evidence supporting their routine use in CKD patients is limited. There is an unmet need for studying interventions for male and female sexual dysfunction in CKD considering the significant disease burden.
Collapse
Affiliation(s)
- Mariacristina Vecchio
- Department of Clinical Pharmacology and Epidemiology, Mario Negri Sud Consortium, S Maria Imbaro, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
21
|
Abstract
The objective of this study was to determine the risk factors of erectile dysfunction (ED) for patients entering the dialysis programme with haemodialysis (HD) or peritoneal dialysis (PD). Participants were adult males with sexual partners. They were given the semi-quantitative standard International Index of Erectile Function questionnaire. We added the common risk factors in specially designed questions to cover our objectives. The data were analysed using a multivariate regression model. Fifty-two patients fulfilled the eligibility criteria and completed this questionnaire. Twenty-five were on HD and 27 on PD. Only 17.3% were potent on entry into the study. Among the rest 71% were classified under severe ED. Sexual desire appeared less affected in comparison to other domains. Although 66.6% expressed their interest in treatment for ED, none of the patients received any. Stepwise selection analysis identified the only significant risk factor to be older age. There was no difference between the two populations of HD and PD. It is concluded that ED is very prevalent in men beginning dialysis; it should be assessed and treatment be offered.
Collapse
Affiliation(s)
- A Nassir
- Surgical Department, Um Al-Qura University, and King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
| |
Collapse
|
|
22
|
Nassir A. Sexual function in male patients undergoing treatment for renal failure: a prospective view. J Sex Med 2009; 6:3407-14. [PMID: 19678883 DOI: 10.1111/j.1743-6109.2009.01411.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Chronic renal failure in males causes wide-ranging disturbances including sexual dysfunction. The percentage and progression of sexual dysfunction in patients entering a dialysis program require further evaluation. AIM Our aim was to determine the ongoing effect of standard renal failure treatment on sexual function. METHODS The sexual function was assessed prospectively, upon initiation of dialysis and every 10-12 months while on dialysis or after kidney transplantation. Participants were adult males with sexual partners. MAIN OUTCOME MEASURE The semiquantitative standard International Index of Erectile Function questionnaire was used initially as a baseline and compared with all subsequent follow-up measures. RESULTS Fifty-two patients fulfilled the eligibility criteria and completed the questionnaire. Of the 52 subjects, 25 were on hemodialysis and 27 were on peritoneal dialysis. Only 17.3% of participants were potent upon entry into the study. Of the rest, 71% was classified as suffering from severe erectile dysfunction (ED). Sexual desire appeared less affected when compared with other domains. Of the study participants, 67% expressed an interest in treatment for ED, but only 12% had ever received any such therapy. Follow-up ranged from 10 months to 48 months. After excluding kidney-transplanted patients, ED scores on entry and at four subsequent reassessments were almost identical and showed no significant statistical differences. Patients showed significant improvement in ED score after kidney transplantation, with scores remaining high for 20-36 months of follow-up, compared with pre-transplantation. CONCLUSIONS This prospective study suggests that dialysis does not benefit sexual function, although a benefit was seen in a subset of men undergoing renal transplantation. We conclude that sexual function in men beginning dialysis should be assessed, and treatment for ED should be offered if appropriate.
Collapse
Affiliation(s)
- Anmar Nassir
- Department of Surgery, Um Al-Qura University, Makkah, Saudi Arabia.
| |
Collapse
|
|
23
|
Erectile dysfunction in a sample of patients attending a psychiatric outpatient department. Int J Impot Res 2009; 21:235-9. [PMID: 19516259 DOI: 10.1038/ijir.2009.16] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To assess the prevalence of erectile dysfunction among a sample of patients attending a psychiatric clinic, we administered the International Index of Erectile Function on 108 male patients attending the clinic. We also obtained sociodemographic and clinical variables from the patients. The mean age of the patients studied was 39.6 (s.d.=11.6), with a mean duration of illness of 10.24 (s.d.=8.2) years. There were 46.8% schizophrenics; other diagnoses include bipolar affective disorder, recurrent depressive disorder and substance use disorder. The prevalence of erectile dysfunction was 83%. Age, marital status, current medications and the presence of comorbid medical conditions were significantly associated with erectile dysfunction; however, only age and marital status significantly predicted erectile dysfunction. We concluded that erectile dysfunction is highly prevalent among patients attending the psychiatric clinic, as such inquiries about sexual function should be routinely carried out by clinicians.
Collapse
|
|
24
|
Vecchio M, Navaneethan SD, Strippoli GFM. Interventions for treating sexual dysfunction in patients with chronic kidney disease. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2009. [DOI: 10.1002/14651858.cd007747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
|
25
|
Messina LE, Claro JA, Nardozza A, Andrade E, Ortiz V, Srougi M. Erectile dysfunction in patients with chronic renal failure. Int Braz J Urol 2008; 33:673-8. [PMID: 17980064 DOI: 10.1590/s1677-55382007000500008] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2007] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Determine the prevalence of erectile dysfunction in patients undergoing hemodialysis. MATERIALS AND METHODS This cross-sectional study was carried out to determine the prevalence of erectile dysfunction in a population of 58 patients in hemodialysis program. Erectile dysfunction was assessed by using the International Index of Erectile Function (IIEF). Information on demographic data, renal failure, comorbidities, laboratory tests and search for medical treatment for erectile dysfunction by means of interviews and researches in medical charts was obtained. Student t test was utilized to compare the laboratory results between group of patients with and without erectile dysfunction. The chi-square test was utilized to compare the comorbidities and the characteristics of the population studied between the groups of patients with and without erectile dysfunction. The significance level considered was 5%. RESULTS Mean patient age was 50.2 +/- 14.6 years and the time of hemodialysis was 30.4 +/- 28.4 months. The prevalence of erectile dysfunction was 60.3%. A progressive increase respecting the age was reported. In patients younger than 50 years, this prevalence reached 31.4% and in patients older than 50 years, this prevalence reached 68.6%. With respect to the comorbidities, hypertensive patients prevailed with 94.8% of the total, whilst diabetic patients represented 24.9%. However only the association between diabetes and erectile dysfunction was significant. Patients with erectile dysfunction presented significantly lower values for serum creatinine and Kt/V. There was no variation between the groups with reference to calcium, potassium, phosphorus, hematocrit, hemoglobin, pre- and post-dialysis urea values. There was no correlation between erectile dysfunction and time of dialysis. Amongst patients with erectile dysfunction, 8.6% sought medical care. CONCLUSIONS The prevalence of erectile dysfunction in patients in hemodialysis program was of 60.3%. Age, diabetes and hemodialysis characteristics are associated to higher incidence of erectile dysfunction.
Collapse
Affiliation(s)
- Leonardo E Messina
- Section of Urology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil.
| | | | | | | | | | | |
Collapse
|
|
26
|
[Erectile dysfunction and renal chronic insufficiency: etiology and management]. Prog Urol 2008; 19:1-7. [PMID: 19135635 DOI: 10.1016/j.purol.2008.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2008] [Revised: 06/28/2008] [Accepted: 07/08/2008] [Indexed: 01/23/2023]
Abstract
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.
Collapse
|
|
27
|
Soh J, Katsuyama M, Ushijima S, Mizutani Y, Kawauchi A, Yabe-Nishimura C, Miki T. Localization of increased insulin-like growth factor binding protein-3 in diabetic rat penis: implications for erectile dysfunction. Urology 2008; 70:1019-23. [PMID: 18068478 DOI: 10.1016/j.urology.2007.07.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2005] [Revised: 06/20/2007] [Accepted: 07/18/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Diabetes-induced erectile dysfunction (ED) is assumed to result from neurovascular abnormalities. However, the entire picture of the molecular mechanisms underlying ED has not yet been clarified. To elucidate the possible elements involved in ED in diabetes mellitus, we performed broad-scale gene expression profiling using cDNA array in the penis of streptozotocin-induced diabetic rats. METHODS Northern blot analysis was performed to examine the course of the mRNA expression encoded by the identified gene. Immunohistochemistry was performed to identify the cellular localization of the encoded protein. RESULTS Of the genes investigated, the expression level of insulin-like growth factor binding protein 3 (IGFBP-3) was greatly increased at 12 weeks after streptozotocin treatment. The levels of ErbB3 epidermal growth factor receptor-related proto-oncogene, G1/S-specific cyclin D2, hepatic neutral cholesteryl ester hydrolase precursor, UDP-galactose ceramide galactosyltransferase, and serine protease RNK-Met-1 were markedly decreased. Increased levels of IGFBP-3 mRNA were demonstrated as early as 2 weeks after induction of hyperglycemia. Increased IGFBP-3 protein was localized to the epithelium of the urethra, penile endothelium, and smooth muscle in the corpus cavernosum. Significant depletion of the smooth muscle density relative to the connective tissue was first observed in the penis of the 8-week diabetic rats, and a significant reduction in the intracavernous pressure was demonstrated only at 12 weeks after the induction of hyperglycemia. CONCLUSIONS These results suggest that the increased expression of IGFBP-3 during hyperglycemia might play an important role in the development of ED.
Collapse
Affiliation(s)
- Jintetsu Soh
- Department of Urology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan.
| | | | | | | | | | | | | |
Collapse
|
|
28
|
Ng EML, Cheng JYW. Prevalence and biopsychosocial correlates of erectile dysfunction in Hong Kong: a population-based study. Urology 2007; 70:131-6. [PMID: 17656223 DOI: 10.1016/j.urology.2007.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Revised: 02/05/2007] [Accepted: 03/02/2007] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To describe the prevalence of erectile dysfunction (ED) in Hong Kong and identify the biopsychosocial correlates of ED. METHODS This was a descriptive and analytic population-representative cross-sectional study of ED in Hong Kong. The study subjects were 1506 men aged 26 to 70 years, recruited by two-stage stratified random sampling, and interviewed face-to-face by trained interviewers with structured questionnaires. RESULTS The overall prevalence of ED was 36.7% (95% confidence interval [CI] 33.7 to 39.7). The age-specific prevalence rate was 18.3% (95% CI 11.1% to 25.4%), 28.6% (95% CI 23.5% to 33.6%), 37.9% (95% CI 32.3% to 43.5%), 47.3% (95% CI 40.1% to 54.5%), and 61.1% (95% CI 51.1% to 71.0%) for the age groups 26 to 30, 31 to 40, 41 to 50, 51 to 60, and 61 to 70 years, respectively. The severity of ED increased with age (P <0.01), and sexual satisfaction decreased with age (P = 0.01). Age (odds ratio [OR] 1.26, P <0.01), living on Hong Kong Island (OR 0.71, P = 0.04), General Health Questionnaire score (OR 1.03, P <0.01), current smokers of 30 or more cigarettes per day (OR 2.11, P = 0.05), and hours spent on work, housework, and self-study (OR 0.945, P = 0.03) were independently associated with ED. CONCLUSIONS To our knowledge, this is the first population-representative study of ED in Hong Kong. The prevalence and severity of ED increased with age, and we found biological (age), psychological (General Health Questionnaire), and social (smoking, Hong Kong district, "hours spent on work") factors to have independent influences on ED. The negative association between "hours spent on work" and ED is a novel finding. The results of this study have shown that Hong Kong has a high prevalence of ED compared with Western populations.
Collapse
Affiliation(s)
- Emil M L Ng
- Department of Psychiatry, University of Hong Kong; Queen Mary Hospital, Hong Kong
| | | |
Collapse
|
|
29
|
Cheng JYW, Ng EML, Chen RYL, Ko JSN. Prevalence of erectile dysfunction in Asian populations: a meta-analysis. Int J Impot Res 2006; 19:229-44. [PMID: 16929338 DOI: 10.1038/sj.ijir.3901517] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We searched for published studies on the prevalence of erectile dysfunction (ED) in Asian populations, through Medline, PubMed, PsychInfo and scanned through reference lists. Data on prevalence rates were obtained and summarized for each Asian region, and were used to calculate pooled prevalence estimates using fixed and random effects models. As significant heterogeneity existed in certain age group categories, the random effects model was preferred. Twenty general population studies were identified. Six studies were eligible to be entered into the pooling of results, and provided 8653 subjects for analysis. The prevalence of ED increased with age. Pooled random effects age-specific prevalence rates were 15.1% (12.2-18.1), 29.6% (19.7-39.6), 40.6% (23.6-57.7), 54.3% (36.0-72.6) and 70.0% (62.3-77.7) for age groups 20-29, 30-39, 40-49, 50-59 and 60-69 years, respectively. Homogeneity of results in age groups 20-29 and 60-69 years suggested equally low and high prevalences of ED across Asian regions in these age groups, respectively. The overall reported prevalence in individual studies ranged from 2 to 81.8%. Prevalence rates and related information were summarized for each Asian region and for each study.
Collapse
Affiliation(s)
- J Y W Cheng
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR.
| | | | | | | |
Collapse
|
|
30
|
Ali MEM, Abdel-Hafez HZ, Mahran AM, Mohamed HZ, Mohamed ER, El-Shazly AM, Gadallah AM, Abbas MA. Erectile dysfunction in chronic renal failure patients undergoing hemodialysis in Egypt. Int J Impot Res 2005; 17:180-5. [PMID: 15549139 DOI: 10.1038/sj.ijir.3901286] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In clinical practice, the attention given to sexual problems in patients with end-stage renal disease is low. In order to evaluate the erectile function in chronic renal failure patients undergoing hemodialysis (HD) as a renal replacement therapy in upper Egypt, we used the abridged version of the International Index of Erectile Function (IIEF-5). In all, 75 HD patients were subjected to clinical and laboratory investigations. The controls were 948 healthy males representing the general Egyptian population. The prevalence of erectile dysfunction (ED) among the HD patients was 82.5% compared to 30% among controls. The prevalence of ED in HD group was significantly higher than in controls. The prevalence of ED in HD patients <50 y was 80% and it was 88% in those > or =50 y, while the prevalence of ED among controls was 28 and 69.8%, respectively. The prevalence of severe degree of ED was significantly higher in both groups compared to controls, while moderate degree of ED showed a statistical significance compared to controls in age groups <50 y and mild degree of ED showed a statistical significance compared to controls in age groups > or =50 y. [corrected] Age (r=-0.3368, P<0.01), serum urea (r=-0.5974, P<0.001), and creatinine level (r=-0.5804, P<0.001) have a significant negative correlation with the presence of ED among HD patients, while serum hemoglobin (r=0.3396, P<0.001) and years of HD age (r=0.3147, P<0.01) have a significant positive correlation with the presence of ED among the HD patients. In view of the observed high prevalence of ED among the HD patients, we believe that a complete health evaluation of male HD patients should include a discussion about erectile function in the standard clinical care program of patients with renal disease.
Collapse
Affiliation(s)
- M-E M Ali
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | | | | | | | | | | | | | | |
Collapse
|
|
31
|
Lau JTF, Kim JH, Tsui HY. Prevalence of male and female sexual problems, perceptions related to sex and association with quality of life in a Chinese population: a population-based study. Int J Impot Res 2005; 17:494-505. [PMID: 15920459 DOI: 10.1038/sj.ijir.3901342] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The prevalence of sexual problems (SP) and sexual satisfaction and their associations with sex-related perceptions and quality of life (QOL) were investigated by interviewing 3257 and 1568 Chinese adults in Hong Kong by a specially designed computerized telephone-interviewing method. SP was prevalent among male (50.9%) and female (54%) respondents; approximately 50% were dissatisfied with their sexual life. Of respondents, 23.9% of men and 5.9% of women perceived sex as important and 52.5% for men and 33.8% of women reported adequate sexual knowledge. The prevalence of SP ranged from 3.4% (pain) to 29.7% (premature orgasm) for men and 6.9% (anxiety) to 24.7% (lack of interest) for women. Prevalence of erectile and lubrication problems were 9.6 and 23.6%, respectively. Sex-related knowledge, perceived importance of sex, perceived physical health status, sexual satisfaction were predictors of SP. Gender differences and strong cultural influences appear to exist. Moreover, SP and sexual satisfaction were associated with mental health and vitality QOL and overall life satisfaction.
Collapse
Affiliation(s)
- J T F Lau
- Centre for Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | | | | |
Collapse
|
|
32
|
Miralles-García JM, García-Díez LC. Specific aspects of erectile dysfunction in endocrinology. Int J Impot Res 2004; 16 Suppl 2:S10-2. [PMID: 15496851 DOI: 10.1038/sj.ijir.3901237] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Prominent diseases of the endocrine system, such as diabetes mellitus, hypogonadism, and hyperprolactinemia, may cause erectile dysfunction (ED). ED affects about 50% of male diabetic patients possibly due to the vascular and neuropathic complications. Metabolic control and selective phosphodiesterase type 5 inhibitors are therapies of choice for controlling ED. By correcting hypogonadism, testosterone levels are restored. This, and the use of dopaminergic drugs, which normalize prolactin levels in male hyperprolactinemia, may be effective in reversing ED in these endocrine disorders.
Collapse
Affiliation(s)
- J M Miralles-García
- Servicio de Endocrinología, Hospital Clínico Universitario, Paseo de San Vicente, Salamanca, Spain
| | | |
Collapse
|
|
33
|
Miyata Y, Shindo K, Matsuya F, Noguchi M, Nishikido M, Koga S, Kanetake H. Erectile dysfunction in hemodialysis patients with diabetes mellitus: Association with age and hemoglobin A1c levels. Int J Urol 2004; 11:530-4. [PMID: 15242363 DOI: 10.1111/j.1442-2042.2004.00838.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Erectile dysfunction (ED) is common in patients with diabetes mellitus (DM) as well as those undergoing hemodialysis (HD). The purpose of this study is to investigate the frequency and severity of ED in HD patients with DM and those without DM. In addition, we examined the relationship between erectile function and several risk factors, including presence of DM and hemoglobin A1c levels in HD patients. METHODS This study involved 180 patients on HD, including 66 HD patients with DM (DM-HD) and 114 patients without DM (non-DM-HD). We evaluated erectile function using an abridged five-item version of the international index of erectile function (IIEF-5). Logistic regression analysis was used to investigate the relationship between presence of ED and several risk factors. RESULTS The total score of IIEF-5 in DM-HD patients (9.5 +/- 4.2) was significantly lower than in non-DM-HD patients (13.5 +/- 5.7). The prevalence of severe ED was 42.4% and 18.4% in DM-HD patients and non-DM-HD patients, respectively. Age, cardiovascular disease history, and DM were identified as independent risk factors for the presence of ED. Furthermore, age and elevated hemoglobin A1c levels were identified as independent risk factors for the presence of severe ED. CONCLUSION DM-HD patients are more likely to have ED, and particularly severe forms of ED, than non-DM-HD patients. DM and elevated hemoglobin A1c levels were associated with the presence of ED or severe ED, respectively. Aging was identified as an independent factor in both ED and severe ED.
Collapse
Affiliation(s)
- Yasuyoshi Miyata
- Department of Urology, Nagasaki University School of Medicine, Sakamoto, Nagasaki city, Japan.
| | | | | | | | | | | | | |
Collapse
|
|
34
|
Naya Y, Mizutani Y, Ochiai A, Soh J, Kawauchi A, Fujito A, Nakamura N, Ono T, Iwamoto N, Aoki T, Marumo K, Murai M, Miki T. Preliminary report of association of chronic diseases and erectile dysfunction in middle-aged men in Japan. Urology 2003; 62:532-6. [PMID: 12946762 DOI: 10.1016/s0090-4295(03)00383-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To investigate the effect of chronic diseases on erectile dysfunction (ED) in Japanese middle-aged men using the International Index of Erectile Function, 5-item version (IIEF-5). METHODS The subjects consisted of 640 healthy men and 396 men with chronic disease who responded to the IIEF-5 questionnaire (mean age 43.6 +/- 8.3 years, range 30 to 59). The incidence and severity of ED were calculated in three age groups (30 to 39, 40 to 49, and 50 to 59 years). RESULTS The incidence of hypertension, cardiac disease, diabetes mellitus, and chronic renal failure was associated with the incidence and severity of ED, as was age. In stepwise multivariate logistic regression analysis, cardiac disease was the strongest independent risk factor (odds ratio [OR] 6.5), followed by diabetes mellitus (OR 5.9), chronic renal failure (OR 3.9), hypertension (OR 2.0), and age (OR 1.8). CONCLUSIONS The results of this study demonstrated that the risk of ED increases with the presence of cardiac disease, diabetes mellitus, chronic renal failure, and hypertension in middle-aged men in Japan.
Collapse
Affiliation(s)
- Yoshio Naya
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
35
|
Goldstein I. Self-Administered Questionnaires in the International Journal of Impotence Research: The Journal of Sexual Medicine. Int J Impot Res 2003. [DOI: 10.1038/sj.ijir.3901027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|