Does Kidney Transplantation Help Young Patients on Dialysis With Erectile Dysfunction? A Single-center Study



      to investigate the effects of a successful KT on EF in male patients with ESRD.

      Materials and Methods

      A single-center cross-sectional prospective study to assess the erectile dysfunction in male patients one month before and one year after KT. We adopted a validated, self-administered translated International Index of Erectile Function (IIEF-15) questionnaire. A sub-analysis was performed by categorizing the cohort into 2 age groups: <50 and ≥50 yr.


      Between September 2017 and February 2021, 68 ESRD patients underwent kidney transplantation (KT), with a mean age of 48.9 ± 12.9 years. Thirty-one patients were below 50 years (Group I). The median hemodialysis duration was 12 months. Sixty-three patients (92.6%) had ED. The mean total IIEF-15 score before and after was 46.8/75 ±12.7 and 55.5 ±13, respectively (P <.001). Forty-six patients (67.6%) reported improved erectile function, 22 (32.4%) did not demonstrate any change, and no patient reported deterioration. Moreover, after KT, sexual desire, orgasm, and overall patient satisfaction improved significantly. Before KT, 83.8% and 100% of groups I and II patients had ED, which dropped to 22.6% and 86.5%, respectively, after KT. IIEF-15 scores improved in both groups. However, the improvement in ED was observed significantly in young patients with mild ED.


      KT positively impacts sexual function and improves erectile dysfunction, especially among young patients. The duration of dialysis before kidney transplantation had no impact on ED improvement after transplantation. The positive effect of transplantation on ED could encourage ESRD patients to undergo KT.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • National Institutes of Health (NIH)
        Consensus development panel on impotence. impotence.
        JAMA. 1993; 270: 83-90
        • Teng LC
        • Wang CX
        • Chen L.
        Improved erectile function and sex hormone profiles in male Chinese recipients of kidney transplantation.
        Clin Transplant. 2011; 25: 265-269
        • Rahman IA
        • Rasyid N
        • Birowo P
        • Atmoko W
        Effects of renal transplantation on erectile dysfunction: a systematic review and meta-analysis.
        Int J Impot Res. 2021; (Jun 8Online ahead of print. PMID:34103695)
        • Feldman HA
        • Goldstein I
        • Hatzichristou DG
        • Krane RJ
        • McKinlay JB.
        Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study.
        J Urol. 1994; 151: 54-61
        • Deshpande A
        • Hayes MH
        • Schootman M.
        Epidemiology of diabetes and diabetes-related complications.
        PysicalTher. 2008; 88: 1254-1266
        • Rebollo P
        • Ortega F
        • Valdés C
        • et al.
        Factors associated with erectile dysfunction in male kidney transplant recipients.
        Int J Impot Res. 2003; 15: 433-438
        • Kleinclauss F
        • Kleinclauss C
        • Bittard H.
        Erectile dysfunction in renal failure patients and renal transplant recipients.
        Prog Urol. 2005; 15: 447-455
        • Lim HJ
        • Koo TY
        • Lee J
        • et al.
        Health-related quality of life of kidney transplantation patients: results from the Korean cohort study for outcome in patients with kidney trans- plantation (KNOW-KT) study.
        Transplant Proc. 2016; 48: 844-847
        • Jabali SS
        • Saleem ZSM
        • Mohammed AA
        • Mahmood NM
        Erectile dysfunction pre and post kidney transplant recipients in Duhok city; cross sectional study.
        Ann Med Surg (Lond). 2020; 55 (May 16. eCollection 2020 Jul): 107-110
        • Russo D
        • Musone D
        • Alteri V
        • et al.
        Erectile dysfunction in kidney transplanted patients: efficacy of sildenafil.
        J Nephrol. 2004; 17: 291
        • Abdel-Hamid IA
        Mechanisms of vasculogenic erectile dysfunction after kidney transplantation.
        BJU Int. 2004; 94: 497
        • Arslan D
        • Aslan G
        • Sifil A
        • et al.
        Sexual dysfunction in male patients on hemodialysis: assessment with the International Index of Erectile Function (IIEF).
        Int J Impot Res. 2002; 14: 539-542
        • Malavaud B
        • Rostaing L
        • Rishmann P
        • Sovramon JP
        • Durand D.
        High prevalence of erectile dysfunction after renal transplantation.
        Transplantation. 2000; 69: 2121-2124
        • Mirone V
        • Longo N
        • Fusco F
        • et al.
        Renal transplantation does not improve erectile function in hemodialysed patients.
        Eur Urol. 2009; 56: 1047
        • Bellinghieri G
        • Santoro G
        • Santoro D
        • et al.
        Ultrastructural changes of corpora cavernosa in men with erectile dysfunction and chronic renal failure.
        Semin Nephrol. 2004; 24: 488-491
        • Giannotti G
        • Landmesser U.
        Endothelial dysfunction as an early sign of atherosclerosis.
        Herz. 2007; 32: 568-572
        • Kaufman JM
        • Hatzichristou DG
        • Mulhall JP
        • Fitch WP
        • Goldstein I
        Impotence and chronic renal failure: a study of the hemodynamic pathophysiology.
        J Urol. 1994; 151: 612-618
        • Costabile RA
        Optimizing treatment for diabetes mellitus induced erectile dysfunction.
        Urol. 2003; 170: S35-S39
        • Chu SH
        • Tay SK
        • Chiang YJ
        • et al.
        Male sexual performance and hormonal studies in uremic patients and renal transplant recipients.
        Transplant Proc. 1998; 30: 3062
        • El-Bahnasawy MS
        • El-Assmy A
        • El-Sawy E
        • et al.
        Critical evaluation of the factors influencing erectile function after renal transplantation.
        Int J Impot Res. 2004; 16: 521
        • Charmet GP
        Sexual Function in Dialysis Patients, Psychological and Physiological Aspects of Chronic Renal Failure.
        Karger Publishers, Basel Switzerland1990: 15-23 (transplantation on sperm quality and sex hormone levels. BJU Int. 2003; 92:281–3)
        • Kantarci G
        • Sahin S
        • Uras AR
        • Ergin H.
        Effects of different calcineurin inhibitors on sex hormone levels in transplanted male patients.
        Transplant Proc. 2004; 36: 178
        • Huyghe E
        • Zairi A
        • Nohra J
        • Kamar N
        • Plante P
        • Rostaing L.
        Gonadal impact of target of rapamycin inhibitors (sirolimus and everolimus) in male patients: an overview.
        Transpl Int. 2007; 20: 305
        • Stanley E.
        • ALTHOF
        Quality of life and erectile dysfunction.
        Urology. 2002; 59.6: 803-810
        • Fugl-Meyer AR
        • Lodnert G
        • Bra ̈nholm I-B
        • et al.
        On life satisfaction in male erectile dysfunction.
        Intern J Impot Res. 1997; 9: 1414-1418