El-Assmy Ahmed
Ahmed El-Assmy, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt.
World J Nephrol. 2012 Dec 6;1(6):160-5. doi: 10.5527/wjn.v1.i6.160.
Men with chronic renal failure (CRF) on hemodialysis have been frequently associated with erectile dysfunction (ED), with an of between 20% to 87.7%. As a result of the multi-system disease processes present in many uremic men, it is apparent that the pathogenesis of ED is most probably multifactorial. Factors to be considered include peripheral vascular disease, neurogenic abnormalities, hormonal disturbances and medications used for treatment of conditions associated with CRF. These physiological abnormalities may be supplemented by significant psychological stresses and abnormalities resulting from chronic illness. Treatment must start with the determination and treatment of the underlying causes. In addition to psychological treatment, further lines of treatment of ED in CRF can be classified as 1st line (medical treatment which includes oral phosphodiesterase-5 inhibitors and hormone regulation), 2nd line (intracavernosal injection, vacuum constriction devices and alprostadil urethral suppositories) or 3rd line (surgical treatment). Renal transplantation improves the quality of life for some patients with CRF and subsequently it may improve erectile function in a significant number of them, however still there is high incidence of ED after transplantation.
接受血液透析的慢性肾衰竭（CRF）男性患者常伴有勃起功能障碍（ED），发生率在20%至87.7%之间。由于许多尿毒症男性存在多系统疾病进程，显然ED的发病机制很可能是多因素的。需要考虑的因素包括外周血管疾病、神经源性异常、激素紊乱以及用于治疗与CRF相关病症的药物。这些生理异常可能会因严重的心理压力和慢性病导致的异常而加重。治疗必须从确定并治疗潜在病因开始。除心理治疗外，CRF患者ED的进一步治疗方法可分为一线治疗（包括口服磷酸二酯酶-5抑制剂和激素调节的药物治疗）、二线治疗（海绵体内注射、真空收缩装置和前列地尔尿道栓剂）或三线治疗（手术治疗）。肾移植改善了一些CRF患者的生活质量，随后可能会使相当一部分患者的勃起功能得到改善，然而移植后ED的发生率仍然很高。
