Background. Erectile dysfunction (ED) is common in end-stage renal disease (ESRD) patients, particularly those on hemodialysis (HD), in whom the incidence is > 80%. Such patients have a reduced quality of life and impaired social function. However, while effective treatment is now readily available, its utilization by such patients is unknown. Patients and Methods. ED in 40- to 70-year-old males was evaluated by the International Index of Erectile Function (IIEF), a self-administered questionnaire. Of the 42 pre-dialysis and dialysis patients and the 44 patients with normal renal function or mild renal dysfunction who were studied, those who believed that they suffered from ED also were asked what remedies they had tried, as well as their success. Results. ED was found more commonly in the dialysis/pre-dialysis group when compared to the group with normal or mildly impaired renal function (79% vs. 27%, p < 0.01). Furthermore, dialysis/pre-dialysis patients with ED were less likely to use sexual intercourse substitutes or to attempt medical therapy when compared to the normal/mildly impaired group (18% vs. 42%, p < 0.05). Conclusion. Severe ESRD not only causes ED but is associated with a relative reluctance of patients to seek a remedy despite experiencing sexual dissatisfaction. The detection of ED in this population by the treating physician is critical and should lead to an active program that includes behavior modification.
Dialysis & Transplantation Vol. 34, no. 2, p. 101-104