Kidney-pancreas transplantation is associated with near-normal sexual function in uremic type 1 diabetic patients

Transplantation. 2011 Oct 15;92(7):802-8. doi: 10.1097/TP.0b013e31822c6eb8.

Abstract

Background: Sexual function is altered in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD), thus affecting quality of life. The present study aimed to analyze sexual function in patients with T1D and ESRD (T1D+ESRD) who received a simultaneous kidney-pancreas (KP) or kidney-alone (KD) transplantation.

Methods: Ten KP, 10 KD, 9 T1D+ESRD patients and 11 healthy control subjects were evaluated according to the following parameters: (1) medical/sexual history and physical examination; (2) International Index of Erectile Function; (3) Beck's inventory for depression; (4) assessment of hormonal profile; (5) quantitative sensory testing of both hand and penile sensory thresholds; and (6) hemodynamic penile assessment.

Results: Controls and KP patients showed a higher rate of self-reported satisfactory erectile function as compared with KD and T1D+ESRD patients. Circulating androgens level resulted lower in both groups of transplanted patients and in patients with T1D+ESRD compared with healthy controls, albeit a relatively better profile was observed in KP. Both transplanted and T1D+ESRD patients showed peripheral hyposensitivity; however, healthy controls and KP showed better penile hemodynamic parameters compared with KD and T1D+ESRD.

Conclusions: Our study demonstrates that sexual function, circulating sex steroids milieu, penile sensitivity, and hemodynamics are near-normalized for the most part in KP transplantation. Further studies are needed to assess the beneficial role and the overall impact of KP transplantation on sexual function in a long-term setting and a larger cohort of patients.

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Case-Control Studies
  • Comorbidity
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Erectile Dysfunction / physiopathology
  • Hemodynamics / physiology
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / physiopathology
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Pancreas Transplantation / physiology*
  • Penis / blood supply
  • Penis / physiopathology
  • Sexual Behavior / physiology*
  • Uremia / epidemiology
  • Uremia / etiology
  • Uremia / physiopathology*

Substances

  • Blood Glucose