Kleinclauss François, Kleinclauss Colette, Bittard Hugues
Service d'Urologie, Hôpital Saint Jacques, Besançon, France.
Prog Urol. 2005 Jun;15(3):447-55; discussion 455-6.
The frequency of erectile dysfunction can be increased in certain populations, such as patients with renal failure in whom the incidence of erectile dysfunction is estimated to be between 50% to 70% depending on the stage of renal failure. In this population, even more than in the general population, erectile dysfunction appears to be due to multiple aetiologies, combining organic and psychological disorders. Although renal transplantation is the treatment of choice for end-stage renal failure, it appears to have very variable effects on erectile dysfunction, as it may improve erectile dysfunction in the same way as global quality of life. However, some authors have demonstrated the aggravating role of renal transplantation on quality of erection, or even de novo appearance of erectile dysfunction. Progress in the fields of dialysis and renal transplantation have considerably improved the quality of life of patients with chronic renal failure. However, this improvement of quality of life does not always concern the patient's sex life. The main causes of erectile dysfunction in haemodialysed patients are endocrine disorders, uraemic neuropathy, tissue lesions related to chronic renal failure, and drugs. These factors of erectile dysfunction are partially corrected by transplantation, but other factors can subsequently be involved, such as drugs or vascular causes. The objective of this study is therefore to conduct a review of the literature on erectile dysfunction (epidemiology, pathophysiology, treatment) in patients with end-stage renal failure (dialysis) and after renal transplantation.
在某些人群中,勃起功能障碍的发生率可能会增加,比如肾衰竭患者,根据肾衰竭的阶段不同,勃起功能障碍的发生率估计在50%至70%之间。在这一人群中,与普通人群相比,勃起功能障碍似乎更是由多种病因引起的,包括器质性和心理性疾病。虽然肾移植是终末期肾衰竭的首选治疗方法,但它对勃起功能障碍的影响似乎非常多变,因为它可能与整体生活质量一样,以相同的方式改善勃起功能障碍。然而,一些作者已经证明肾移植对勃起质量有加重作用,甚至会导致勃起功能障碍的新发。透析和肾移植领域的进展显著改善了慢性肾衰竭患者的生活质量。然而,这种生活质量的改善并不总是涉及患者的性生活。血液透析患者勃起功能障碍的主要原因是内分泌紊乱、尿毒症神经病变、与慢性肾衰竭相关的组织病变以及药物。这些勃起功能障碍的因素通过移植可部分得到纠正,但随后可能会涉及其他因素,如药物或血管原因。因此,本研究的目的是对关于终末期肾衰竭(透析)患者及肾移植后勃起功能障碍(流行病学、病理生理学、治疗)的文献进行综述。