El-Bahnasawy Magdy Salama, El-Assmy Ahmed, Dawood Ahmed, Abobieh Essam, Dein Bedeir Ali-El, El-Din Ahmed Bayoumi Shehab, El-Hamady Salah El-Din
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
J Urol. 2004 Dec;172(6 Pt 1):2335-9. doi: 10.1097/01.ju.0000144403.03734.11.
We determined the effects of the use of internal iliac artery for renal transplantation on erectile function and penile hemodynamics in prospective fashion.
The study comprised 50 patients with chronic renal failure on hemodialysis without associated vascular risk factors. All patients were evaluated before and after renal transplantation with 6-month followup. All grafts were revascularized with end-to-end anastomosis to the right internal iliac artery. Before and after transplantation the patients were evaluated by detailed history, including the International Index of Erectile Function, clinical examination, laboratory investigations and pharmacodynamic penile color duplex ultrasonography.
Erectile dysfunction was reported by 28% of the patients with chronic renal failure. This incidence becomes 26% after transplantation. Based on questionnaires post-transplantation erectile function compared to pre-transplant status was improved, deteriorated or remained static in 40%, 18% and 42% of transplant recipients, respectively. The International Index of Erectile Function showed no differences between pre-transplantation and posttransplantation sexual function except in the domain of sexual desire. In comparison to preoperative penile indices, there was a significant decrease in penile arterial blood flow in the 2 cavernous arteries (p <0.05). However, none of the patients had penile arterial insufficiency.
Renal transplantation has varying effects on erectile function. In the majority of cases it has no negative effect on the quality of erection. In the absence of associated vascular risk factors unilateral interruption of the internal iliac artery decreases arterial penile blood flow but not to a degree that compromise erectile function.
我们前瞻性地确定了在肾移植中使用髂内动脉对勃起功能和阴茎血流动力学的影响。
该研究纳入了50例接受血液透析的慢性肾衰竭患者，这些患者无相关血管危险因素。所有患者在肾移植前后均进行了评估，并随访6个月。所有移植物均通过与右髂内动脉进行端端吻合实现血管重建。在移植前后，通过详细病史对患者进行评估，包括国际勃起功能指数、临床检查、实验室检查以及阴茎彩色双功能超声的药效学检查。
28%的慢性肾衰竭患者报告存在勃起功能障碍。移植后这一发生率变为26%。根据问卷调查，移植后勃起功能与移植前状态相比，分别有40%、18%和42%的移植受者有所改善（变好）、恶化或保持不变。国际勃起功能指数显示，除性欲领域外，移植前和移植后的性功能无差异。与术前阴茎指标相比，两条海绵体动脉的阴茎动脉血流显著减少（p<0.05）。然而，没有患者存在阴茎动脉供血不足。
肾移植对勃起功能有不同影响。在大多数情况下，它对勃起质量没有负面影响。在不存在相关血管危险因素的情况下，单侧阻断髂内动脉会减少阴茎动脉血流，但程度不至于损害勃起功能。
