Impact of renal transplant on gonadal function

Objectives: We aimed at creating a clinical profile of end-stage renal disease patients' gonadal function and assessing the impact of renal transplant on gonadal dysfunction. We studied the influence of age, vascular anastomosis, dialysis vintage, and immunosuppression on sexual dysfunction. Materials and Methods: Twenty adults were included. Hormones (luteinizing hormone [LH], follicle-stimulating hormone [FSH], testosterone, prolactin (PRL), and estrogen), menstrual history and International Index of Erectile Function (IIEF)-5 questionnaires were assessed before and after renal transplantation. Hormone evaluation was done by chemiluminescent microparticle immunoassay technology. Results: Seventeen patients were male and three patients were female. Native kidney diseases were chronic glomerulonephritis (10%), IgA nephropathy (20%), autosomal dominant polycyctic kidney disease (5%), diabetic nephropathy (5%), focal segmental glomerulosclerosis (5%), renal calculus disease (5%), membranous nephropathy (5%), and pauci-immune vasculitis (5%). Fifteen males had erectile dysfunction (ED) before transplant. Eleven patients showed an increase and six patients showed a decrease in IIEF scores posttransplantation. Statistically significant changes were observed in the mean levels of testosterone, LH, PRL, and FSH. Age at transplant showed a negative correlation with IIEF score. In five patients with an end to side anastomosis to the external iliac artery, all had an increase in IIEF score posttransplant. In 12 patients with an end to end anastomosis to the internal iliac artery, 5 patients (42%) had a decrease in IIEF score posttransplant. Conclusions: Incidence of ED was 88% in our study. About 65% patients showed an increase in IIEF score posttransplantation. Increasing age at the time of transplant was a significant risk factor for the presence of ED. Renal transplantation corrected hormonal abnormalities in men. About 100% of patients with an end to side arterial anastomosis showed improvement in IIEF scores. There was no effect of dialysis vintage and immunosuppression regimes on sexual dysfunction