Introduction: Erectile Dysfunction (ED) is defined as the inability to achieve or
maintain an erection sufficient for sexual intercourse. The frequency of erectile
dysfunction in patients with kidney failure is estimated at 50% to 70%. The
objective of this work was to determine the frequency of sexual dysfunction in
chronic hemodialysis patients, to evaluate the psycho-social impact and to describe
hormonal disturbances. Patients and Methods: This was a descriptive
prospective study carried out from 3 April to 31 August 2017 in the nephrology
and haemodialysis department of the Point G University Hospital. She has been
interested in men over the age of 18 who have been on chronic hemodialysis for
more than a year. Sexual dysfunction was assessed using the questionnaire:
International Index of Erectile Function (IIEF-5). Results: Sixty-five
patients were included. Forty-six (70.8%) had severe (30.8%), moderate (13.8%)
and mild (26.2%) ED.56.9%
of patients had libido disorders, with decreased sexual desire (38.5%); absent
sexual desire (18.5%). Sexual desire was normal in 43.1% of patients. Sexual
activity was absent in 20 patients (30.8%). Sexual rigidity was reduced in 28
patients (43.1%) and normal in 24 patients (36.9%). The mean age of our
patients was 42.55 years with a median age of 40 years and extremes of 23 and
74 years. Eighty percent were married. Nine patients (13.8%) were using
sildenafil-based
medications. Antihypertensives were prescribed in 93.9% and erythropoietin in
30.8% of patients. The main impact groups were anxiety (53.8%), fear of failure
(27.7%), insomnia (7.7%) and anxiety (6.1%). And defence mechanisms included:
understanding (54.7%); isolation (24.6%); repression (7.7%); quarrel (7.7%);
and divorce in 1 case (1.5%). The occurrence of ED was related to
hypotestosterolemia (p = 0.030), and between low libido and testosterone (p = 0.001).
Nutritional status was satisfactory in 78.4% of our patients. Moderate and at
and severe undernutrition was found in equal proportions (10.8%) in our
patients with a statistically significant relationship with
References
[1]
Carson, C.C., Kirby, R.S. and Goldstein, I. (1999) Textbook of Erectile Dysfunction. Isis Medical Media, Oxford, 917-922.
[2]
Kleinclauss, F., Kleinclauss, C. and Bittard, H. (2005) Erectile Dysfunction in Patients with Renal Insufficiency and Renal Transplantation. Advances in Urology, 15, 447-456.
[3]
Phé, V., Roupret, M., Ferhi, K., Barrou, B., Cussenot, O. and Traxer, O. (2009) Etiology and Management of Erectile Dysfunction in Chronic Renal Failure. Advances in Urology, 19, 1-7. https://doi.org/10.1016/j.purol.2008.07.003
[4]
Avakoudjo, J., Paré, A., Vigan, J., Gandaho, I., Hounasso, P. and Hodonou, R. (2012) Erectile Dysfunction in Haemodialysis Patients at the CNHU-HKM in Cotonou: Epidemiological Profile. Andrologie, 22, 246-251.
https://doi.org/10.1007/s12610-012-0201-4
[5]
Cisse, M., et al. (2014) Erectile Dysfunction in Chronic Dialysis Patients in Dakar. Néphrologie & Thérapeutique, 10, 329.
https://doi.org/10.1016/j.nephro.2014.07.102
[6]
Levy, N.B. (1973) Sexual Adjustment to Maintenance Hemodialysis and Renal Transplantation; National Survey by Questionnaire; Preliminary Report. Transactions—American Society for Artificial Internal Organs, 19, 138-143.
https://doi.org/10.1097/00002480-197301900-00025
[7]
Peces, R., Horcajada, C. and Lopez-Novoa, J.M. (1981) Hyperprolactinemia in Chronic Renal Failure: Impaired Responsiveness to Stimulation and Suppression. Nephron, 28, 11-16. https://doi.org/10.1159/000182087
[8]
Kharbach, Y., Bourouhou, H., Tenkorang, S., Mellasa, S., El Ammari, J.E. and Tazi, M.F. (2016) Correlations between Sexual Dysfunction and the Clinico-Biological Profile of Renal Failure in Hemodialysis. African Journal of Urology, 22, 310-314.
[9]
Leonardo, E.M., Joaquim, A.C., Archimedes, N., Enrico, A., Valdemar, O. and Miguel, S. (2007) Erectile Dysfunction in Patients with Chronic Renal Failure. International Brazilian Journal of Urology, 33, 673-678.
https://doi.org/10.1590/S1677-55382007000500008
[10]
Strippoli, G.F.M. (2012) Sexual Dysfunction in Women with ESRD Requiring Hemodialysis. Clinical Journal of the American Society of Nephrology, 7, 974-981.
https://doi.org/10.2215/CJN.12601211
[11]
Malekmakan, L., Shakeri, S., Haghpanah, S., Pakfetrat, M., Sadeghi, S. and Malekmakan, A. (2011) Epidemiology of Erectile Dysfunction in Hemodialysis Patients Using IIEF Questionnaire. Saudi Journal of Kidney Diseases and Transplantation, 22, 232-236.
[12]
Naya, Y., Soh, J., Ochiai, A., Ochiai, A., Mizutani, Y., Ushijima, S., et al. (2002) Significant Decrease of the International Index of Erectile Function in Male Renal Failure Patients Treated with Hemodialysis. International Journal of Impotence Research, 14, 172-177. https://doi.org/10.1038/sj.ijir.3900854
[13]
Ahmed, E.A. (2012) Erectile Dysfunction in Hemodialysis: A Systematic Review. World Journal of Nephrology, 1, 160-165. https://doi.org/10.5527/wjn.v1.i6.160
[14]
Sawin, C.T., Longope, G., Schmitt, G.W. and Ryan, R.S. (1973) Blood Levels of Gonadotrophins and Gonadal Hormones in Gynecomastia Associated with Chronic Hemodialysis. The Journal of Clinical Endocrinology & Metabolism, 36, 988-990.
https://doi.org/10.1210/jcem-36-5-988
[15]
Tourkantonis, A., Spiliopoulos, A., Pharmakiotis, A. and Settas, L. (1981) Haemodialysis and Hypothalamo-Pituitry-Testicular Axis. Nephron, 27, 271-272.
https://doi.org/10.1159/000182066
[16]
Messina, L., Claro, J. and Nardozza, A. (2007) Erectile Dysfunction in Patients with Chronic Renal Failure. International Brazilian Journal of Urology, 33, 673-678.
https://doi.org/10.1590/S1677-55382007000500008
[17]
Lobna, A., Rim, M., Asma, B.H., Fadwa, C., Faical, J., Jamil, H., et al. (2015) Sexual Disorders in the Hemodialysis Patient. La Tunisie Médicale, 93, 79-84.
[18]
Buvat, J., Ratajczyk, J. and Lemaire, A. (2002) Erection Problems: A Suffering That Is Still Too Often Hidden. Andrology, 12, 73-83.
https://doi.org/10.1007/BF03034950
[19]
Zbiti, N., Benrais, N., Ould Mohamed, A., Hamzaoui, H., Rhou, H., Ouzeddoun, N., et al. (2010) Gonadal Disorders in Male Chronic Hemodialysis. J Maroc Urol, 22.
