Effect of maintenance hemodialysis on male sexual performance.

Prior studies have suggested that male patients with uremia suffer from sexual dysfunction that worsens when they are placed on maintenance hemodialysis. The authors report a prospective study of the effect of maintenance hemodialysis on male sexual functioning using nocturnal penile tumescence (NPT) measures and detailed sexual histories. Twenty men already on maintenance hemodialysis and 23 men with advanced renal failure who began maintenance hemodialysis within 4 months of entering the study were followed at 4-month intervals for 1-year and 6-month intervals for the following 18 months. Sexual performance as assessed by NPT, frequency of intercourse, and complaints of erectile failure remained remarkably stable over time for both groups. When renal failure patients moved to maintenance hemodialysis, their frequency of intercourse increased significantly despite stability of NPT. These results suggest not only that maintenance hemodialysis does not worsen sexual functioning, but that adaptation to a sexual deficit is possible after starting hemodialysis.