Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study

Introduction. The prevalence of erectile dysfunction in men with chronic kidney disease stage V is from 60 to 80%. At the same time, the prevalence of erectile dysfunction in patients after kidney transplantation remains high at up to 60%. One of the possible causes of erectile dysfunction after kid...

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Main Authors: A. R. Zagitov, F. N. Mukhamedyanov, A. A. Izmailov, L. M. Kutliyarov, V. N. Pavlov
Format: Article
Language:Russian
Published: Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education 2019-02-01
Series:Вестник урологии
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Online Access:https://www.urovest.ru/jour/article/view/232
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author A. R. Zagitov
F. N. Mukhamedyanov
A. A. Izmailov
L. M. Kutliyarov
V. N. Pavlov
author_facet A. R. Zagitov
F. N. Mukhamedyanov
A. A. Izmailov
L. M. Kutliyarov
V. N. Pavlov
author_sort A. R. Zagitov
collection DOAJ
description Introduction. The prevalence of erectile dysfunction in men with chronic kidney disease stage V is from 60 to 80%. At the same time, the prevalence of erectile dysfunction in patients after kidney transplantation remains high at up to 60%. One of the possible causes of erectile dysfunction after kidney transplantation is considered a decrease in arterial inflow to the cavernous bodies of the penis.Objectives. Тo evaluate the results of treatment of ED in patients after KT, depending on the vascular anastomosis.Materials and methods. 84 patients with a functioning kidney after transplantation were examined. All patients were divided into 3 groups: Group I – 38 patients undergoing KT with arterial vascular anastomosis with an internal iliac artery; Group II – 46 patients undergoing kidney transplantation with arterial vascular anastomosis to external iliac artery; Group III – 35 healthy volunteers (control group) with no history of urological diseases or surgical interventions on the pelvic organs. International Index of Erectile Function Index (IIEF-5) was used to assess erectile function. An ultrasound study with dopplerography of the penile arteries was performed before and after intracavernous pharmacological stress. For treating patients with erectile dysfunction after kidney transplantation were used PDE-5 inhibitors (Tadalafil® 5 mg daily for 3 months, then at a dose of 20 mg “on demand”), a special set of exercises for the muscles of the pelvic floor, vacuum therapy and physiotherapy with the device “Androgyne”.Results. Significant erectile function disorders were detected in 26 (68.4%) patients of group I, and in 31 (73.9%) patients of group II, according to data from the IIEF-5 questionnaire. Group I 27 (71.1%) patients were satisfied with sex life, group II – 39 (84.8%) by the end of the year. According to the Doppler ultrasound, after 12 months in patients of group I, the maximum systolic velocity of blood flow in the right and left cavernous artery of the penis was 25.0 ± 3.44 cm / s and 33.0 ± 3.56 cm / s, respectively. The difference in arterial inflow of 8 cm / s indicates a pronounced arterial perfusion of the penis in group I patients. At the same time, in patients of group II, the maximum systolic velocity was significantly higher than in group I and amounted to 40.1 ± 2.66 cm/s and 40.0 ± 2.77 cm/s, respectively.Conclusion. The data obtained indicate a decrease in the arterial inflow to the penis along the right cavernous artery in patients from group I, who underwent an arterial vascular anastomosis with an internal iliac artery during kidney transplantation.
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spelling doaj-art-d29348147e6b4ba69a008144f69ae0cb2025-08-20T03:57:18ZrusMinistry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional EducationВестник урологии2308-64242019-02-0164212610.21886/2308-6424-2018-6-4-21-26178Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up studyA. R. Zagitov0F. N. Mukhamedyanov1A. A. Izmailov2L. M. Kutliyarov3V. N. Pavlov4Bashkir State Medical University.Bashkir State Medical University.Bashkir State Medical University.Bashkir State Medical University.Bashkir State Medical University.Introduction. The prevalence of erectile dysfunction in men with chronic kidney disease stage V is from 60 to 80%. At the same time, the prevalence of erectile dysfunction in patients after kidney transplantation remains high at up to 60%. One of the possible causes of erectile dysfunction after kidney transplantation is considered a decrease in arterial inflow to the cavernous bodies of the penis.Objectives. Тo evaluate the results of treatment of ED in patients after KT, depending on the vascular anastomosis.Materials and methods. 84 patients with a functioning kidney after transplantation were examined. All patients were divided into 3 groups: Group I – 38 patients undergoing KT with arterial vascular anastomosis with an internal iliac artery; Group II – 46 patients undergoing kidney transplantation with arterial vascular anastomosis to external iliac artery; Group III – 35 healthy volunteers (control group) with no history of urological diseases or surgical interventions on the pelvic organs. International Index of Erectile Function Index (IIEF-5) was used to assess erectile function. An ultrasound study with dopplerography of the penile arteries was performed before and after intracavernous pharmacological stress. For treating patients with erectile dysfunction after kidney transplantation were used PDE-5 inhibitors (Tadalafil® 5 mg daily for 3 months, then at a dose of 20 mg “on demand”), a special set of exercises for the muscles of the pelvic floor, vacuum therapy and physiotherapy with the device “Androgyne”.Results. Significant erectile function disorders were detected in 26 (68.4%) patients of group I, and in 31 (73.9%) patients of group II, according to data from the IIEF-5 questionnaire. Group I 27 (71.1%) patients were satisfied with sex life, group II – 39 (84.8%) by the end of the year. According to the Doppler ultrasound, after 12 months in patients of group I, the maximum systolic velocity of blood flow in the right and left cavernous artery of the penis was 25.0 ± 3.44 cm / s and 33.0 ± 3.56 cm / s, respectively. The difference in arterial inflow of 8 cm / s indicates a pronounced arterial perfusion of the penis in group I patients. At the same time, in patients of group II, the maximum systolic velocity was significantly higher than in group I and amounted to 40.1 ± 2.66 cm/s and 40.0 ± 2.77 cm/s, respectively.Conclusion. The data obtained indicate a decrease in the arterial inflow to the penis along the right cavernous artery in patients from group I, who underwent an arterial vascular anastomosis with an internal iliac artery during kidney transplantation.https://www.urovest.ru/jour/article/view/232erectile disfunctionchronic kidney diseasekidney transplantationdoppler ultrasound of penile vessels
spellingShingle A. R. Zagitov
F. N. Mukhamedyanov
A. A. Izmailov
L. M. Kutliyarov
V. N. Pavlov
Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study
Вестник урологии
erectile disfunction
chronic kidney disease
kidney transplantation
doppler ultrasound of penile vessels
title Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study
title_full Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study
title_fullStr Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study
title_full_unstemmed Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study
title_short Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study
title_sort treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis results of short term follow up study
topic erectile disfunction
chronic kidney disease
kidney transplantation
doppler ultrasound of penile vessels
url https://www.urovest.ru/jour/article/view/232
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