The Impact of Hemodialysis on Sexual Function in Male Patients using the International Index of Erectile Function Questionnaire (IIEF)
Keywords:
International Index of Erectile Function (IIEF), sexual dysfunction, chronic kidney diseaseAbstract
Introduction: Routine hemodialysis is one of the preferred treatment methods in patients with chronic kidney disease. It seems that routine hemodialysis can be effective in improving sexual function in these patients. This study aimed to determine the effect of routine dialysis sessions over a six-month period on the status of sexual function in men with chronic renal failure using the International Index of Erectile Function (IIEF) questionnaire.
Methods: The cross-sectional study was conducted from November 2015 to November 2016 on patients with chronic renal failure who were first-time candidates for routine hemodialysis and who were referred to Imam Reza Hospital of Mashhad. All of the patients completed the IIEF questionnaire before their first hemodialysis. Afterwards, all of the patients underwent routine dialysis sessions over a six-month period and completed the IIEF questionnaire again at the end of the sixth month. The prevalence of sexual dysfunction was assessed before and after hemodialysis. The scores on the two IIEF questionnaires were compared according to five domains, i.e., erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. The comparisons were done before and after hemodialysis using the paired-samples t-test. Statistical analyses were performed using SPSS version 19.
Results: The study included 30 men with a mean age of 40.2 ± 8.2. The prevalence of sexual dysfunctions in the order of their frequency was as follows: intercourse satisfaction (100%), overall satisfaction (100%), sexual desire (96.7%), orgasmic function (93.3%), and erectile function (90%). After six months of treatment with hemodialysis, the ratings of all areas of sexual dysfunction were improved significantly (p-value = 0.00 for all domains).
Conclusion: According to the results of this study, it seems that a six-month course of hemodialysis can improve erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction in patients with chronic kidney disease.
References
Messina LE, Claro JA, Archimedes N, Andrade E, Ortiz V, Srougi M. Erectile dysfunction in patients with
chronic renal failure. Int braz j urol. 2007; 33(5): 673-8. doi: 10.1590/S1677-55382007000500008. PMID:
Coelho-Marques F, Wagner M, De Figueiredo CP, d'Avila D. Quality of life and sexuality in chronic
dialysis female patients. Int J Impot Res. 2006; 18(6): 539-43. doi: 10.1038/sj.ijir.3901470. PMID:
El-Assmy A. Erectile dysfunction in hemodialysis: A systematic review. World J Nephrol. 2012; 1(6): 160- 5. doi: 10.5527/wjn.v1.i6.160. PMID: 24175255, PMCID: 3782219.
Miyata Y, Shindo K, Matsuya F, Noguchi M, Nishikido M, Koga S, et al. Erectile dysfunction in
hemodialysis patients with diabetes mellitus: association with age and hemoglobin A1c levels. Int j urol.
; 11(7): 530-4. PMID: 15242363.
Peng YS, Chiang CK, Hung KY, Chiang SS, Lu CS, Yang CS, et al. The association of higher depressive
symptoms and sexual dysfunction in male haemodialysis patients. Nephrol Dial Transplant. 2007; 22(3):
-61. doi: 10.1093/ndt/gfl666. PMID: 17121784.
Messina LE, Claro JA, Nardozza A, Andrade E, Ortiz V, Srougi M. Erectile dysfunction in patients with
chronic renal failure. Int braz j urol. 2007; 33(5): 673-8. PMID: 17980064.
Coelho-Marques FZ, Wagner MB, Poli de Figueiredo CE, d'Avila DO. Quality of life and sexuality in
chronic dialysis female patients. Int J Impot Res. 2006; 18(6): 539-43. PMID: 16554852.
Weiss P, Brody S. International Index of Erectile Function (IIEF) scores generated by men or female
partners correlate equally well with own satisfaction (sexual, partnership, life, and mental health). j sex
med. 2011; 8(5): 1404-10. doi: 10.1111/j.1743-6109.2011.02214.x. PMID: 21324092.
Bass A, Ahmed SB, Klarenbach S, Culleton B, Hemmelgarn BR, Manns B. The impact of nocturnal
hemodialysis on sexual function. BMC nephrol. 2012; 13: 67. PMID: 22834992. PMCID: 3457870.
Malekmakan L, Shakeri S, Haghpanah S, Pakfetrat M, Sarvestani AS, Malekmakan A. Epidemiology of
erectile dysfunction in hemodialysis patients using IIEF questionnaire. Saudi J Kidney Dis Transpl. 2011;
(2): 232-6. PMID: 21422619.
Mumtaz A, Anees M, Barki MH, Sami W, Hussain S, Nazir M. Erectile dysfunction in haemodialysis
patients. J Ayub Med Coll Abbottabad. 2009; 21(2): 4-7. PMID: 20524457.
Arslan D, Aslan G, Sifil A, Cavdar C, Celebi I, Gamsari T, et al. Sexual dysfunction in male patients on
hemodialysis: assessment with the International Index of Erectile Function (IIEF). Int J Impot Res. 2002;
(6): 539-42. doi: 10.1038/sj.ijir.3900937. PMID: 12494292.
Mekki MO, El Hassan KA, El Mahdi EM, Haroun HH, Mohammed MA, Khamis KH, et al. Prevalence and
associated risk factors of male erectile dysfunction among patients on hemodialysis and kidney transplant
recipients: a cross-sectional survey from Sudan. Saudi J Kidney Dis Transpl. 2013; 24(3): 500-6. PMID:
Lai CF, Wang YT, Hung KY, Peng YS, Lien YR, Wu MS, et al. Sexual dysfunction in peritoneal dialysis
patients. Am J Nephrol. 2007; 27(6): 615-21. PMID: 17851229.
Krishnan R, Izatt S, Bargman JM, Oreopoulos D. Prevalence and determinants of erectile dysfunction in
patients on peritoneal dialysis. Int Urol Nephrol. 2003; 35(4): 553-6. PMID: 15198165.
Pourmand G, Emamzadeh A, Moosavi S, Mehrsai A, Taherimahmoudi M, Nikoobakht M, et al. Does renal
transplantation improve erectile dysfunction in hemodialysed patients? What is the role of associated
factors? Transplant Proc. 2007; 39(4): 1029-32. doi: 10.1016/j.transproceed.2007.03.038. PMID:
Mehrsai A, Mousavi S, Nikoobakht M, Khanlarpoor T, Shekarpour L, Pourmand G. Improvement of
erectile dysfunction after kidney transplantation: the role of the associated factors. Urol j. 2006; 3(4): 240- 4. PMID: 17559049.
Makarem AR, Karami MY, Zekavat OR. Erectile dysfunction among hemodialysis patients. Int Urol
Nephrol. 2011; 43(1): 117-23. doi: 10.1007/s11255-010-9780-1, PMID: 20535636.
Van Eps CL, Jeffries JK, Johnson DW, Campbell SB, Isbel NM, Mudge DW, et al. Quality of life and
alternate nightly nocturnal home hemodialysis. Hemodialysis international International Symposium on
Home Hemodialysis. Hemodial Int. 2010; 14(1): 29-38. doi: 10.1111/j.1542-4758.2009.00419.x. PMID:
Lockridge RS Jr, Spencer M, Craft V, Pipkin M, Campbell D, McPhatter L, et al. Nightly home
hemodialysis: five and one-half years of experience in Lynchburg. Virginia. Hemodial Int. 2004; 8(1): 61- 9. doi: 10.1111/j.1492-7535.2004.00076.x. PMID: 19379403.
Ting GO, Kjellstrand C, Freitas T, Carrie BJ, Zarghamee S. Long-term study of high-comorbidity ESRD
patients converted from conventional to short daily hemodialysis. Am J kidney dis. 2003; 42(5): 1020-35.
PMID: 14582046.
McPhatter LL, Lockridge RS Jr, Albert J, Anderson H, Craft V, Jennings FM, et al. Nightly home
hemodialysis: improvement in nutrition and quality of life. Adv Ren Replace Ther. 1999; 6(4): 358-65.
PMID: 10543717.
Mehraban D, Shabaninia SH, Naderi GH H, Esfahani F. Farsi International Index of Erectile Dysfunction
and Doppler Ultrasonography in the Evaluation of Male Impotence. Iranian Journal of Surgery. 2006;
(1): 25-31.
Bellomo R, Mansfield D, Rumble S, Shapiro J, Parkin G, Boyce N. Acute renal failure in critical illness.
Conventional dialysis versus acute continuous hemodiafiltration. ASAIO j. 1992; 38(3): M654-7. PMID:
25) Laumann EO. The social organization of sexuality: Sexual practices in the United States: University of
Chicago Press; 1994.
Palmer BF. Sexual dysfunction in men and women with Chronic Renal Failure and end-stage kidney
disease. Adv Ren Replace Ther. 2003; 10(1): 48-60. doi: 10.1053/jarr.2003.50003. PMID: 12616463.
Holdsworth S, De Kretser D, Atkins R. A comparison of hemodialysis and transplantation in reversing the
uremic disturbance of male reproductive function. Clin nephrol. 1978; 10(4): 146-50. PMID: 363318.
Diemont WL, Vruggink PA, Meuleman EJ, Doesburg WH, Lemmens WA, Berden JH. Sexual dysfunction
after renal replacement therapy. Am j kidney dis. 2000; 35(5): 845-51. doi: 10.1016/S0272-6386(00)70254- X. PMID: 10793018.
Charney DL, Walton DF, Cheung AK, editors. IMPOTENCE: II. Seminars in Dialysis; 1994: Wiley Online
Library.
Steele TE, Wuerth D, Finkelstein S, Juergensen D, Juergensen P, Kliger AS, et al. Sexual experience of the
chronic peritoneal dialysis patient. J Am Soc Nephrol. 1996; 7(8): 1165-8. PMID: 8866408.
Toorians A, Janssen E, Laan E, Gooren L, Giltay E, Oe PL, et al. Chronic renal failure and sexual
functioning: clinical status versus objectively assessed sexual response. Nephrol dial transplant. 1997;
(12): 2654-63. doi: 10.1093/ndt/12.12.2654.
Lim VS, Fang VS. Restoration of plasma testosterone levels in uremic men with clomiphene citrate. J Clin
Endocrinol Metab. 1976; 43(6): 1370-7. doi: 10.1210/jcem-43-6-1370, PMID: 1002820.
Tsujimura A, Matsumiya K, Tsuboniwa N, Yamanaka M, Miura H, Kitamura M, et al. Effect of renal
transplantation on sexual function. Arch Androl. 2002; 48(6): 467-74. doi: 10.1080/01485010290099381.
PMID: 12425764.
Zamd M, Gharbi MB, Ramdani B, Zaid D. Sexual dysfunction in male patients undergoing hemodialysis in
morocco. Saudi J Kidney Dis Transpl. 2005; 16(1): 33-9. PMID: 18209457.
Nassir A. Erectile dysfunction risk factors for patients entering dialysis programme. Andrologia. 2010;
(1): 41-7. PMID: 20078515.
Martin-Diaz F, Reig-Ferrer A, Ferrer-Cascales R. [Sexual function and quality of life in hemodialysis male
patients]. Nefrologia. 2006; 26(4): 452-60. PMID: 17058857.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.