Le disfunzioni sessuali maschili in pazienti con insufficienza renale cronica end stage ed in pazienti sottoposti a trapianto renale

[Autom. eng. transl.] Aim of the work The aim of the present study was to evaluate the prevalence of sexual dysfunctions (erectile dysfunction and hypogonadism) in male patients suffering from chronic renal failure (CRF) end-stage in hemodialysis treatment and in patients undergoing kidney transplantation. Factors predisposing to erectile dysfunction (ED) were also evaluated, with particular attention to the hormonal setting in the two groups of patients. Materials and methods The study was conducted on 95 patients aged between 20 and 65 years: 44 undergoing dialysis treatment for more than a year and 51 undergoing renal transplantation for more than 6 months. Comorbidities were accurately recorded, erectile function was assessed with the IIEF5 questionnaire and serum levels of total / free testosterone and prolactin were tested. To evaluate the relationships between ED and clinical-laboratory tests, the Student T statistical tests (quantitative variables), the chi-square (qualitative variables), the uni and multivariate analysis were used. Results High dialysis prevalence was found in patients receiving dialysis and those undergoing a renal transplant, in 70% and 65% of cases, respectively. Among patients over the age of 50, the percentage of those with ED is much greater than that of subjects without ED, respectively 61% vs. 31%, p = 0.006 in dialysis patients; hyperprolactinemia was found in 23% and 20% of the two groups, respectively. 59% of dialysis patients in the group had total plasma testosteronemia values below 250ng / dl with a significant difference between those with ED and those without ED (65% vs. 46%, p = 0.019), whereas in transplanted was found only in 37%; furthermore, its correlation with the onset of ED does not appear to be statistically significant (p = 0.12). Univariate and multivariate analysis showed 200 posters significantly correlated with ED over the age of 50, diabetes and hypotestosteronemia. Discussion Patients with end-stage chronic renal failure show a marked deterioration in quality of life, sexual dysfunction and in particular high frequency of erectile dysfunction due to comorbidities, the disease itself but also related therapies. The end-stage IRC is a factor that accelerates and aggravates the pathophysiological mechanisms underlying the appearance of ED that normally occur with age. Conclusions DE in patients with end-stage CRF and in those who have benefited from transplantation has a marked prevalence; this element, which often escapes or is little emphasized in the literature. Hypotestosteronemia appears to be a risk factor for the onset of ED in patients with end-stage chronic renal failure. The prevalence of significantly lower hypogonadism between transplanted and dialysed patients suggests that renal transplantation may have a protective role in the sexual sphere of these patients.