End-stage renal disease (ESRD) and dialysis have negative impact on lifestyle. Renal transplantation improves many facets of daily life. Male sexuality is a significant predictor of quality of life. This brief review summarizes the impacts of ESRD and renal replacement on a range of sexual domains as presented at the European Association of Urology meeting in Vienna.
In choosing renal transplantation, men expect superior long-term survival compared to other means of renal replacement. Moreover, men undergoing renal transplantation can expect improvements in quality of life, increased activity, and hopefully see a return to normality in their lives. For many men, sex is an important contributor to quality of life. This review looks at the complex of interaction of end-stage renal disease (ESRD), renal replacement therapy, and sexuality in men. Impact of Sexuality on Perceived Quality of Life The Transplant Learning Center has looked at the various factors thought to impact on quality of life among kidney transplant recipients.1 Data from 4247 solid organ transplants were collected at 3-month interval regarding adverse events, life satisfaction, and posttransplant care. …show more content…
Regression analysis was then performed looking at health-related quality of life (HRQOL). They found after adjusting for age, gender, and time since transplantation that sexuality accounted for the most variance in life satisfaction (16.5% of variance), followed by headaches (15.7%), altered body shape (13.6%), and swelling of hands and feet (13%). A further study from the same center followed a cohort of patients posttransplant longitudinally over 1 year. On regression analyses, again they found that impaired sexuality correlated well with HRQOL.2 Clearly, sexuality is a strong predictor of perceived quality of life. Risk Factors for Renal Impairment and Sexual Dysfunction Hypertension occurs in up to 85% of patients who have undergone renal transplant due to factors such as preexisting hypertension, renal artery stenosis, renal transplant dysfunction, immunosuppressive medication, obesity, and lifestyle.2, 9 and 10 Although control of hypertension may improve overall quality of life, hypertension itself and the drugs that treat it both have a negative impact on erectile function. Diabetes mellitus is the most common cause of CRF leading to renal transplant. Patients with type 1 diabetes mellitus accrue benefit to HRQOL when treated by combined pancreas-kidney transplantation.3 However, type 2 diabetes is a significant cause for ESRD in the developed world. Furthermore, in the United States up to a quarter of patients develop diabetes mellitus within 3 years of undergoing renal transplant.4 Anemia is also seen increasingly as a problem after transplantation. Up to 70% of all transplant recipients experience anemia early after transplant, and a large minority remain anaemic 5 years after transplantation. Anemia reduces libido and erectile function. Impact of Renal Impairment on Sexuality Men who are kept alive by renal replacement may have disturbed physiology that impacts the various spheres of sexuality, namely sexual desire, erectile function, orgasm, ejaculation, overall satisfaction, and the psyche. …show more content…
The home circumstances of patients who are on hemodialysis, CAPD or who have had a renal transplant compared to another chronic illness, rheumatoid arthritis were described by Toorians et al.5 Patients undergoing hemodialysis have higher rates of divorce than the other three conditions. Of those receiving renal replacement who are in relationships, 79% to 93% describe themselves as sexually active and between 92% and 100% as having happy relationship. There are several ways renal replacement therapy impacts sexuality. Hormonal
In choosing renal transplantation, men expect superior long-term survival compared to other means of renal replacement. Moreover, men undergoing renal transplantation can expect improvements in quality of life, increased activity, and hopefully see a return to normality in their lives. For many men, sex is an important contributor to quality of life. This review looks at the complex of interaction of end-stage renal disease (ESRD), renal replacement therapy, and sexuality in men. Impact of Sexuality on Perceived Quality of Life The Transplant Learning Center has looked at the various factors thought to impact on quality of life among kidney transplant recipients.1 Data from 4247 solid organ transplants were collected at 3-month interval regarding adverse events, life satisfaction, and posttransplant care. …show more content…
Regression analysis was then performed looking at health-related quality of life (HRQOL). They found after adjusting for age, gender, and time since transplantation that sexuality accounted for the most variance in life satisfaction (16.5% of variance), followed by headaches (15.7%), altered body shape (13.6%), and swelling of hands and feet (13%). A further study from the same center followed a cohort of patients posttransplant longitudinally over 1 year. On regression analyses, again they found that impaired sexuality correlated well with HRQOL.2 Clearly, sexuality is a strong predictor of perceived quality of life. Risk Factors for Renal Impairment and Sexual Dysfunction Hypertension occurs in up to 85% of patients who have undergone renal transplant due to factors such as preexisting hypertension, renal artery stenosis, renal transplant dysfunction, immunosuppressive medication, obesity, and lifestyle.2, 9 and 10 Although control of hypertension may improve overall quality of life, hypertension itself and the drugs that treat it both have a negative impact on erectile function. Diabetes mellitus is the most common cause of CRF leading to renal transplant. Patients with type 1 diabetes mellitus accrue benefit to HRQOL when treated by combined pancreas-kidney transplantation.3 However, type 2 diabetes is a significant cause for ESRD in the developed world. Furthermore, in the United States up to a quarter of patients develop diabetes mellitus within 3 years of undergoing renal transplant.4 Anemia is also seen increasingly as a problem after transplantation. Up to 70% of all transplant recipients experience anemia early after transplant, and a large minority remain anaemic 5 years after transplantation. Anemia reduces libido and erectile function. Impact of Renal Impairment on Sexuality Men who are kept alive by renal replacement may have disturbed physiology that impacts the various spheres of sexuality, namely sexual desire, erectile function, orgasm, ejaculation, overall satisfaction, and the psyche. …show more content…
The home circumstances of patients who are on hemodialysis, CAPD or who have had a renal transplant compared to another chronic illness, rheumatoid arthritis were described by Toorians et al.5 Patients undergoing hemodialysis have higher rates of divorce than the other three conditions. Of those receiving renal replacement who are in relationships, 79% to 93% describe themselves as sexually active and between 92% and 100% as having happy relationship. There are several ways renal replacement therapy impacts sexuality. Hormonal